Inspection on 30/04/07 for Sixth Avenue, 53-55

This inspection was carried out on 30th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Sixth Avenue, 53-55 22/07/09

Sixth Avenue, 53-55 27/04/09

Sixth Avenue, 53-55 30/01/06

Sixth Avenue, 53-55 15/08/05

Sixth Avenue, 53-55 17/01/05

Sixth Avenue, 53-55 09/09/04

Sixth Avenue, 53-55 27/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Sixth Avenue, 53-55 53-55 Sixth Avenue Blyth Northumberland NE24 2ST Lead Inspector Jim Lamb Unannounced Inspection 30th April 2007 09:30 Sixth Avenue, 53-55 DS0000000646.V330176.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 Sixth Avenue, 53-55 DS0000000646.V330176.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. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sixth Avenue, 53-55 Address 53-55 Sixth Avenue Blyth Northumberland NE24 2ST 01670 - 368717 01670 368693 jacqueline.hutchinson@nhs.net 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) Northumberland, Tyne & Wear NHS Trust Jacqueline Anne Hutchinson Care Home 8 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (3), Mental disorder, excluding of places learning disability or dementia (1) Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user categorised as MD also has a learning disability Date of last inspection 30th January 2006 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. Northgate and Prudhoe Health Trust manage the home. The home is registered to provide personal care to eight adults with learning disabilities and physical disabilities. Fees for the home are £285 per week. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service. The Visit: An unannounced visit was made on 30.04.07 During the visit we: • • • • • • Talked with people who use the service, the staff, and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last inspection. We told the manager what we found. What the service does well: Staff were friendly and relaxed and showed a good understanding of residents needs. Arrangements for residents to maintain contact with their family and friends are good. A variety of social activities were available providing residents with varied and interesting days. Meals are varied, well balanced and offering a good choice and nutritious food at all meals. Meals were seen as a relaxed and social occasion. Hygiene practices were good protecting the health of residents and staff. The home is well staffed with a skilled, consistent and trained staff team giving security to residents. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 6 Staff recruitment and training records include equal opportunities; they were clear and concise and contained all relevant information. The vetting process helps protect residents. The staff had a good understanding of service users individual needs. The assessment form encourages staff to explore issues relating to equality and diversity as it refers to gender, ethnic origin, cultural, religious/spirituality, educational and social histories, preferred daily routine and preferences. It also looks at mood, speech, behaviour, mental health, risks, and living skills. Residents are able to make a choice of staff gender when deciding whom they would like to deliver their care, as the home has male staff as well as the female members. The staff group is balanced to enable choice of male or female staff, according to needs and wishes. Plans are in place to deliver training, which includes, equality and diversity More than eighty percent of staff is qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing residents with a trained, skilled staff team. Eight residents feedback cards were received, they were very complimentary about the staff, and all aspects of the care that they receive. What has improved since the last inspection? What they could do better: No Requirements or recommendations were identified. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 7 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. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 8 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 Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 9 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): 1 2 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. Two service users’ files were checked and each included a full needs assessment. This provides staff with essential information about the individual’s holistic needs, including spiritual beliefs and their wishes following death. The service users are involved in drawing up both these initial assessments and the home’s subsequent service user plans. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 10 The 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. The service users feedback cards all showed their needs were met and they were happy with the care offered to them. Two care plans were checked and staff interviewed, which confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. The care planning system is clear enough to ensure that staff has the information they need to meet the assessed needs of the service users. Service users are supported to make decisions about their lives, and take risks to promote their independence. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a comprehensive risk assessment of service users. Service users and their representatives have agreed these. There are advocacy arrangements, as well as family input, to represent service users. Each service user has an allocated key worker. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 12 Care plans are drawn up with service users. Plans are amended and reviewed on a regular basis. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. Any service users rights that maybe restricted are linked to risk assessments. Service users continue to have access to a range of health care professionals. Currently no service users have any pressure sores. The home receives very good support from the local District Nurse. For one person with challenging behaviour, an effective treatment intervention plan has been implemented, with in-put from specialist health care professionals, and the BAIT Team (Behavioural Analysis Intervention Team). The plan is aimed to maintain the individual’s rights and responsibilities, and protect the service user and others from harm. All potential risks associated with this individual have been identified and managed to minimise potential harm. Checklists and pro formas are in place to aid working with and assessing risks. Staff were observed to act in a very caring and responsible way. They recognised and know at which point to begin putting into effect the behavioural support plan to reduce the impact of the service users behaviour. Service users’ feedback cards all showed that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 13 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 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The meals in the home are good, offering both choice and variety. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Each service user has a skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users can access a range of community-based services. They are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies inside and outside the home. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 14 The service has its own transport, and individual holidays are planned for each service user. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Daily routines promote independence, choice and freedom of movement. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. The staff consults with the service users regarding meals and knows all their likes and dislikes. The manager intends to review the menus, based on service users choice. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 15 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 excellent. This judgement has been made using available evidence including a visit to this service. The health care of the service users is met and there is good multi disciplinary working taking place. The promotion of health care needs is taken seriously. Medication systems are well managed. Personal support is always provided in the way that service users prefer. EVIDENCE: Service users have complex physical and emotional care needs, and require a great deal of help with their personal care tasks, such as transferring, bathing and dressing. Each person has been individually assessed with in-put from various health care professionals. Appropriate aids and equipment are in situ. Privacy and dignity are respected at all times. The need to respect service users privacy and dignity when delivering health and personal care is a key principle of the homes aims and objectives. The homes policies, procedures and guidance support and inform practice. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 16 Induction training also covers privacy and dignity. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. District nurses’ provide very good support and they maintain their own health care records, and they ensure that the service has appropriate aids and equipment in place. Occupational Therapists and Physiotherapists are also consulted regarding advice, support and specialist equipment. The medication systems were examined for ordering, receiving, administering and disposal. The systems are well managed. All staff had undertaken accredited medication training. Controlled drugs are not currently prescribed. Should this change appropriate systems and procedures will be put in place. There is a medication policy which is accessible to staff. Drug alert notifications were filed and available to staff. The medication records contained identification photographs. Currently no service users have the capacity to manage their own medications. The dispensing pharmacist offers good support and advice. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. Service users feedback comment cards, said that they had been given copies of the procedure and that staff listened to their complaints and dealt with them fairly. The home keeps a record of complaints. During the last twelve months there has been no complaints received. The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. The home also has a copy of the Department of Health’s document, “NO SECRETS”. The Home keeps detailed financial records on behalf of the service users, and Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 18 These were found to be accurate. All service users have a personal bank account. Receipts of personal spending are kept. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 19 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 25 26 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally very good. Communal areas and bedrooms are large, and meet the service users needs. All areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and well maintained. The grounds were tidy, safe, attractive and accessible. The fire service and the environmental health department had made visits to the home. No requirements were made. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 20 The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. The environment is fully accessible to people with physical disabilities, adaptations and specialist equipment fit in with a homely environment. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Lighting was bright and domestic in design. Service users’ bedrooms have opening windows. The rooms are centrally heated and the heating level could be controlled within each bedroom. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. A record of water temperatures is kept. The home was clean and fresh. The laundry facilities are well organised. The washing machine has been fitted with a mechanical device with specified programme to meet disinfection standards. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 21 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 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff receives supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Staff levels on the day of the inspection continue to meet the agreed level. Currently there are two staff on maternity leave and another on long term sick leave. Staffing levels are maintained by staff working additional paid hours. Staff are happy with these arrangements. If this situation continues for much longer, and to avoid staff becomig overworked, consideration must be given to employing agency staff. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 22 Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: In addition to the manager, there are 4 staff between 8am and 9pm with 2 staff between 9pm and 8am. A member of staff is also on sleep-in duty. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff continue to be identified in supervision and appraisal sessions. The training programme meets The National Training Organisation requirements for the first six months. All staff receives paid training. An inspector recently visited the Trusts head office to check staff files. There is a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The Trust promotes equal opportunities in the work place. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 23 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 excellent. This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users’ consultation are good, and service user’s views are both sought and acted upon. The health and safety of the service users is promoted. The service is aware of equality and diversity and its implications. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has the appropriate qualifications, experience and skills necessary to manage the service. She has recently commenced a twelve-week dementia awareness diploma course. Service users are told when inspections take place and they will be able to read the new pictorial inspection report. Copies are available for relatives and others to see. The records inspected were found to be appropriately completed. These included the fire log book, accident records, personal allowance records, quality assurance, and the Health and Safey manual. There are appropriate maintenance contracts for the home. A system continues to monitor the quality of the service provided, this involves gaining feedback from service users, relatives and professionals involved with the home, the outcomes will be published and made available to all prospective service users. The home is also has an annual development plan. The equality and diversity agenda is promoted, and staff training has commenced, this is focused on improving outcomes for service users. Water storage tanks, gas and electrics are checked annually. Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 25 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 4 2 4 3 X 4 X 5 3 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 4 25 3 26 3 27 4 28 4 29 3 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 4 X Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. Extracts may not be used or reproduced without the express permission of CSCI Sixth Avenue, 53-55 DS0000000646.V330176.R01.S.doc Version 5.2 Page 28 - 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. 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