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Inspection on 15/08/05 for Sixth Avenue, 53-55

Also see our care home review for Sixth Avenue, 53-55 for more information

This inspection was carried out on 15th August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

The service users are protected and safe guarded from abuse. The home provides a very comfortable environment for service users.

What has improved since the last inspection?

The majority of requirements and recommendations identified during the last inspection visit have been addressed. The home now has a registered manager.

What the care home could do better:

There are several policies and procedures, care records and the homes service users guide that should be produced in a range of formats such as video, or audiotape for the benefit of service users and potential new users of the home. The home must cease the use of door chocks.

CARE HOME ADULTS 18-65 Sixth Avenue 53-55 Sixth Avenue Blyth Northumberland NE24 2ST Lead Inspector Jim Lamb Unannounced 15 August 2005 9:30 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. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sixth Avenue Address 53-55 Sixth Avenue Blyth Northumberland NE24 2ST 01670 368717 01670 368693 sixth@sixthavenue.wanadoo.co.uk Northgate & Prudhoe NHS Trust 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) Debra Margaret McMullen CRH 8 Category(ies) of LD - Learning Disability (4) registration, with number LD(E) - Learning Disability - Over 65 (3) of places MD - Mental Disorder (1) Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: One service user categorised as MD also has a learning disability. Date of last inspection 17 1 05 Brief Description of the Service: 53 and 55 Sixth avenue are two purpose built bungalows situated in the centre of a residential housing estate in Blyth. The home is accessible to the town centre of Blyth and close proximity of local amenities. The home is managed by Northgate and Prudhoe Health Trust. The home is registered to provide personal care to eight adults with learning disabilities and physical disabilities. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first annual unannounced inspection visit. It took place over three hours during the morning. Time was spent examining policies and procedures and service users care records. The inspector spoke to two staff and two service users, and time was spent walking around the home. 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. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 standard(s) 1 3 4 Prospective service users have the information they need to make an informed choice about where to live, information should be made available in a range of formats such as: video, audio tape, etc. Prospective service users needs are appropriately assessed. All prospective service users have the opportunity to visit and to ‘test drive’ the home prior to admission. EVIDENCE: The homes Statement of Purpose and the Service Users Guide both contained the full range of information required. Information should be available in a range of formats eg on audiotape or video. Two service users’ files were checked and on each were a copy of a full needs assessment. These were carried out by appropriately trained people eg - the referring social worker. This did contain a range of appropriate information. The 2 service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 8 Both care plans were checked and staff members interviewed. These confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. All service users are invited to visit the home prior to admission to meet other service users and staff. Overnight stays can also be arranged. Unplanned admissions are avoided where possible. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 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 9 The service users assessed needs and personal goals are reflected in their individual care plans, consideration should be given to providing information other than the written word. Service users are supported to make decisions about their lives and also supported to take risks as part of an independent lifestyle. EVIDENCE: There is evidence of a comprehensive assessment in the service users’ care plans. There is also a comprehensive risk assessment of service users. There was evidence of advocacy arrangements, as well as family input. Each service user has an allocated key worker. Care plans are drawn up with service users. There is evidence that plans are amended and reviewed on a regular basis. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 10 All aspects of standard 7 have been met; self-advocacy is promoted, service users can access a range of external agencies that promote independence, any rights that are restricted are linked to risk assessments. Each service user receives support from staff to manage their finances. Service users’ are supported to make decisions for themselves. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 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 The service users are able to take part in appropriate activities and become involved in community-based activities. Several service users have enjoyed holidays this year and other have holidays planned. Service users are supported to maintain family links. The service users are provided with a healthy diet. EVIDENCE: Each service user has a practical life skills assessment carried out and this is reviewed and updated every six months, all service users participate in this process, and their relatives are invited to attend. Validated intervention treatment programmes are accessed if a need does arise. The service users have access to a range of community-based services, which promote and provide opportunities to learn and use life skills. All service users are supported to maintain very close links with their families. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 12 All are able to choose who they want to see and when. There was evidence that daily routines promote independence, choice and freedom of movement. The inspector observed staff interacting in a sensitive and respectful manner with service users. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided on a daily basis. The inspector was informed that the service users are involved with the food shopping. A range of special diets can be catered for. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.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) 19 20 The service users personal and health care needs are fully met. The homes medication systems are well managed and staff has undertaken medication training. EVIDENCE: The majority of the service users currently have moving and handling needs. There was evidence that moving and handling assessments had been completed and O/T input had been sought. The inspector was informed that privacy and dignity are respected at all times. There was evidence within the service users care records that they have access to external health care services. G.P.’s visit when necessary, and service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The inspector examined the records and the procedures for the administration of medication; these appeared to be appropriately detailed. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 14 No service users are prescribed controlled drugs. Appropriate storage was seen to be in place. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 23 The service users are protected from abuse, neglect and self-harm. Staff has undertaken vulnerable adult protection training. EVIDENCE: The home does have a complaints procedure, which the inspector saw. It contains details of how to contact the CSCI to make a complaint, that complaints would be responded to in 28 days and that complainants would not be victimised. It is recommended that the complaints procedures should be made available in a range of formats such as video or audiotape. The home does keep a record of complaints. Since the last inspection visit there have been no complaints received. The home has a Whistle Blowing policy procedure as well as, the Local Authorities Vulnerable Adults procedures. The home also has a copy of the D.H. “NO SECRETS” for further information. The Home maintains detailed financial records on behalf of the service users; each has an individual bank account. There was evidence of personal spending and receipts are kept. The cash balance held for one service user was checked, this was found to be correct. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 25 26 27 28 29 30 The service users live in a very homely, comfortable and relatively safe environment, however a door chock was in use to hold open a bedroom door, this practice must cease. Funding is currently being sought to replace the baths. EVIDENCE: On the day of the inspection the home was clean, well decorated and well maintained. The home is in a residential location. The grounds were tidy, safe, attractive and accessible. The home does have an appropriate amount of sitting, recreational and dining space. There are sufficient rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. The dining areas are large enough to cater for all service users. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 17 Outdoor space and all areas of the home are accessible to people in wheelchairs. Furnishings and fittings were domestic in design and in good condition. Lighting was sufficiently bright and also domestic in design. Doors were labelled and had privacy locks. There were appropriate aids and adaptations – eg seat raisers, grip rails, bath hoists. However the home must stop the practice of using door chocks. Room sizes did meet the minimum required. Room dimensions were such there was space on either side of the bed when necessary to enable access for carers and specialist equipment. Service users’ bedrooms checked all had opening windows. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators were low surface temperature and pipes were guarded. Lighting levels were sufficient and there was emergency lighting throughout the home. The home was clean and free from offensive odours. The laundry facilities appeared to be well organised. Washing machines have the specified programme to meet disinfection standards. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 18 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 36 The service users appear to be supported by an effective and caring staff team. The additional ancillary hours will certainly enhance the service provided. EVIDENCE: Staff levels on the day of the inspection did meet the agreed level. Samples of 4 weeks’ rotas were checked and these stated the required numbers of staff were on duty. Each bungalow also has an enabler daily Mon-Fri, the inspector was informed that both enablers are prepared to work flexibly ie evenings and week-ends. Staff spoken to said that staffing levels were appropriate and that there were additional staff on duty at peak times of the day. All the staff were over 18 years of age and those left in charge were at least 21. As previously reported, the ancillary hours have been agreed. The inspector checked staff records and found that 75 of the home’s staff is expected to qualify to NVQ level 2 by December 2005. Training needs of staff are identified via supervision and appraisal sessions. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 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 42 Since the last inspection visit the home has a new registered manager. The staff confirmed that there is an open, positive and inclusive atmosphere. Policies and procedures comply with current legislation. There is a system in place to provide a safe and comfortable environment. EVIDENCE: The new registered manager has many years experience in senior management and is working towards a level 4 National Vocational Qualification in management and care. In the last year all of the staff team have attended several courses to keep themselves up to date. Staff interviewed were clear about the their responsibilities. Staff interviewed spoke positively about the manager saying she had encouraged both staff and service users to contribute to the development of the service. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 20 The Trust has developed a range of new policies and procedures which have to some degree been linked to the National Minimum Standards. The records that I inspected were found to be appropriately completed, these included the fire log book, accident book, personal allowance records, Health and Safey manual, and I was provided with information which verified that appropriate maintenance contracts for the home are in place. Finance records have previously been forwarded to the CSCI to verify that the home is viable. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 2 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 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sixth Avenue Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 22 yes 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 YA 1 6 40 Regulation 12(3) 22 (!1) (2) Timescale for action To make information accessible 1.11.05 to service users in other than the outstandig. written word eg The Statement Of Purpose, Service users Guide, Complaints Procedures and appropriate Care Records. Stop the use of door chocks and 1.10.05. provide an alternative approved device in order to hold doors open. Requirement 2. 29 23 (4) 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 No recommendations were identified. Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Sixth Avenue B53-B03 S646 Sixth Avenue V239338 150808 Stage 4.doc Version 1.40 Page 24 - 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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