Inspection on 07/03/07 for 129 Neale Avenue

This inspection was carried out on 7th March 2007.

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

129 Neale Avenue 04/02/09

129 Neale Avenue 07/12/05

129 Neale Avenue 18/01/05

129 Neale Avenue 19/08/04

129 Neale Avenue 17/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Sense (Neale Avenue) 129 Neale Avenue Kettering Northants NN16 9HG Lead Inspector Ruth Wood Key Unannounced Inspection 7th March 2007 1:10pm Sense (Neale Avenue) DS0000044413.V333741.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 Sense (Neale Avenue) DS0000044413.V333741.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. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sense (Neale Avenue) Address 129 Neale Avenue Kettering Northants NN16 9HG 01536 415385 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) debbie.stone@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association Mrs Deborah Joy Stone Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Sense (Neale Avenue) care home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 6 Physical disability (PD) 6 Sensory impairment (SI) 6. The maximum number of persons to be accommodated at Sense (Neale Avenue) is 6. 7th December 2005 2. Date of last inspection Brief Description of the Service: As part of the Sense East organisation, 129 Neale Avenue, Kettering provides specialised personal care for up to six people with profound sensory impairment, learning disability, and physical disability. The property, which is leased from East Lindsay Partnership Housing, trading as Linx Homes, has been extensively renovated by the registered provider, and is well equipped to meet service users’ physical needs. 129 Neale Avenue is a two storey building located in a quiet residential street in Kettering, near to the town centre and its amenities. Internally, there are wide corridors and a purpose built lift provides access to the first floor bedrooms. Bedrooms (all single) have specially designed en suite facilities to cater for people’s physical needs. There are two larger bedrooms on the ground floor with en suite facilities that include specialised baths that can be electrically raised and lowered. The communal facilities include a lounge, dining room and a conservatory area used for activities. There is a large enclosed garden to the rear of the property. Current fee levels at the home are between £2,215 and £3,032 per week. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit took place on a weekday between 1.10pm and 5:50pm. The first part involved discussion with the registered manager, examination of two service users’ support plans and a tour of the building. Other records, including those relating to staff recruitment and training and those relating to service users’ finances were examined. Service users returned home from day activities at approximately 4:30pm. Interaction between service users and staff was observed, the inspector communicated/interacted with two service users and discussed practice and training with staff members. Medication systems and records were also examined. One relative completed and returned one of the Commission’s survey forms and another relative spoke to the Inspector on the telephone. Their views, along with other evidence received prior to the inspection visit, were considered when writing this report. What the service does well: What has improved since the last inspection? A thorough review of support plans is ongoing and these are now very detailed offering clear guidance for staff on how to meet service users’ needs. There is good practice in medication administration and recording; the staff member responsible for this during the inspection displayed a high level of competence and understanding. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is excellent Comprehensive assessment procedures ensure that service users’ needs and aspirations can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sense East has a central, assessment team who visit prospective service users in their existing settings and undertake a comprehensive assessment process. This includes discussion with all those currently involved in supporting the service user, gathering of assessments from other professionals and undertaking direct assessment themselves. Given the communication needs of some service users this involves close and extended observation to ascertain how the individual interacts with other people. The assessment documents for a prospective service user were very comprehensive and detailed. The registered manager had arranged a series of visits to allow the new service user and their existing carers to ‘test drive’ the home before taking the final decision to move in. The manager said that this process was also valuable to see how the new service user would fit in with the people currently living at the home. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good Staff endeavour to help service users make day to day decisions and to take reasonable risks. Support plans accurately reflect service users’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two support plans examined contained detailed information as to how health and personal care needs should be met, a moving and handling assessment, service users’ preferred methods of communication, likes and dislikes in relation to food and activities and cultural and religious requirements. Detailed behaviour support plans were in place and later discussion with staff members suggested that they had read and were following this guidance. Plans also contained assessments relating to areas of risk, particular to that service user. Both plans contained evidence of regular review involving the representatives of the placing authority and relatives. Arrangements for managing service users’ finances have recently been reviewed following an allegation of theft in the home last year and systems and practice is now robust. Financial records and balances of monies held for two service users were checked and found accurate. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 10 It is difficult for many of the home’s service users to express choice but staff endeavour to involve service users in decisions such as what to eat, times to go to their bedroom and what activities to participate in. Staff were observed to use appropriate communication methods (including gesture and sign for some service users) and allow service users sufficient time to respond. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good Service users have opportunities to engage in vocational, leisure and community activities and are supported in maintaining links with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users attend a specialist day service run by Sense East, four days per week and engage in a variety of activities including work (such as shredding paper for offices), cooking and music therapy as well as activities in the wider community such as ice skating and bowling. One relative commented, “The day service is excellent”. Each service user has one day per week at home when they go shopping with support and they will be involved (perhaps only in a very limited way) in some household tasks. Discussion with the registered manager indicated that a lot of time in the evenings was spent attending to service users’ personal care needs particularly bathing, which for many service users is a very enjoyable part of their day. One relative commented that they felt that there should be more social activities for people to do in the evenings and at weekends. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 12 The manager stated that people had been to the theatre at Christmas time to see the pantomime and had also visited the cinema. Day trips had also been arranged in the summer. Service users have the opportunity to go on holiday in small groups, supported by staff and the inspector saw photographs of one holiday last year. Good arrangements are in place to support service users to maintain contact with their families. One relative said that they felt the home always helped their relative maintain contact with them but felt communication between themselves and the home could be a little better. Another relative felt that communication had improved recently. Menu Records showed that generally a reasonable variety of food is served, however one service user is vegetarian and the vegetarian alternative is routinely listed in records as ‘Quorn alternative’. It is recommended that advice be sought on introducing more variety into the meals provided for this service user. Menus should also state what vegetables have been served with the main course so that the nutritional value of meals served can be monitored. Several service users require assistance with eating and there was guidance relating to this in their support plans; advice was also being sought in this area from a speech and language therapist. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good Service users receive appropriate personal support and their health and medication needs are generally well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users’ personal and health care needs are clearly documented in support plans together with a record of all health care appointments. Service users have access to dental and optical services and other specialist services such as speech and language therapy. Some improvement is needed in meeting the chiropody needs of service users. The Registered Manager said that some service users would only tolerate this kind of care from people they knew and trusted therefore support staff in the home cut these service users’ toenails. The Inspector recommended that appropriate training be arranged for staff undertaking this aspect of care. A requirement was made at the previous inspection for assessments relating to pressure area care. Written assessments are still not documented in care plans however there was evidence for effective practice in this area, including the routine use of barrier creams. It is still recommended that formal assessments be conducted and documented to ensure that good practice continues and is appropriately monitored. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 14 Medication is stored appropriately and medication records appeared up-to-date and accurate. The staff member who explained medication procedure displayed a good knowledge and stated that they had received training in administering medication, which was updated regularly. Medication records are checked at the end of each shift to ensure they have been completed correctly. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good Service users are ‘listened’ to and systems are in place to protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Lat year two allegations of practice, which potentially placed service users at risk, had been referred for investigation under the protection of vulnerable adults procedures. These were discussed with the registered manager and evidence of detailed investigation was seen. The response to these allegations was appropriate and ensured the best interests of service users. Individual staff members implicated no longer work at the home and their names have been placed on the vulnerable adults register. Appropriate modifications to practice and procedures have been made in relation to service users’ finances (see Standard 7). The registered manager stated that being involved in these investigations had given her a good insight into how procedures in this area operate and she felt that Sense East offered good support and training in these areas. Staff are also given clear guidance and regular training on challenging behaviour and strategies to use to prevent escalation and safeguard the safety of service users and themselves. Support plans seen, suggested ways in which a service user may communicate their unhappiness with their care and that support staff should be constantly aware of these. One relative, in response to the Commission’ pre-inspection questionnaire said that they knew how to make a complaint and that any concerns they had raised had been responded to appropriately. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good Service users live in a clean and comfortable environment, which meets their needs well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and tidy on the day of inspection and several areas had been re-decorated. Training records show that some staff have received training in infection control Service users’ bedrooms contain specialist equipment to meet their individual needs such as adapted beds, chairs and baths. Appropriate equipment to assist staff with the moving and handling of service users is also in place. Each bedroom has full en-suite facilities and there are additional communal toilet and bathing facilities on each floor. Sense (Neale Avenue) DS0000044413.V333741.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good Service users are supported and protected by well-trained staff and effective recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff undertake a structured induction programme which is designed to teach the key skills needed for working with people with sensory, physical and learning disabilities. Staff said that the training they received prepared them well for their work. Five staff hold a National Vocational Qualification at level 2 or above and a further five are undertaking the level 2 qualification. Relationships observed between staff and service users seemed warm, friendly and appropriate. Staff seemed able to anticipate service users’ needs and interpret their communication. Two staff records were examined; these contained a completed application form, (which included a full employment history), two written references and evidence that a Criminal Records Bureau check had been completed before the staff member started work and that their name had been checked against the Protection of Vulnerable Adults Register. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good Good health and safety practice ensures service users’ welfare in these areas is promoted. Systems are in place to evaluate and improve the quality of service provided and ensure that it meets service users’ needs and best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager holds a National Vocational Qualification at level 4, the Registered Manager’s Award and a Certificate in Managing Care from the Open University. Management systems in place seem to be generally effective although it was noted that staff meetings were poorly attended, one having only the manager and another staff member present. There is a regular system of self-monitoring in place, overseen by Sense East, with a clear report of findings and recommendations being produced which was made available to the Inspector. There was no indication that the quality assurance system involves formal consultation with stakeholders such as commissioners of the service, professionals (such as GPs) or relatives. It is Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 19 recommended that this type of consultation should take place as part of the home’s quality review arrangements. Good systems are in place with regards to health and safety. Documentation and discussion with staff showed that they receive training updates in key areas such as, moving and handling, fire safety, health and safety, infection control, first aid and food hygiene. Electrical and gas systems are regularly maintained as is equipment used in moving and handling (such as hoists). Fire systems are tested weekly and fire systems and equipment were checked on 10.10.06. A Control of Substances Hazardous to Health assessment is also in place. Water temperatures are regularly tested and recorded. Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 20 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 4 3 X 4 3 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 3 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 Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 21 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. 1. 2. Refer to Standard YA17 YA17 Good Practice Recommendations It is recommended that advice be sought on introducing more variety into the meals provided for the service user who is vegetarian. Menu records should state what vegetables and other accompaniments have been served with the main course so that the nutritional value of meals served can be monitored. Appropriate training in foot care should be arranged for staff from a suitably qualified person to ensure service users receive appropriate care in this area. It is recommended that formal assessments be conducted and documented to ensure that good practice in pressure area care continues and is appropriately monitored. It is recommended that consultation with stakeholders such as commissioners of the service, professionals (such as GPs) or relatives should take place as part of the home’s quality review arrangements. 3. 4 5 YA19 YA19 YA39 Sense (Neale Avenue) DS0000044413.V333741.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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