Inspection on 25/01/06 for Tavistock Avenue (12)

This inspection was carried out on 25th January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tavistock Avenue (12) 11/04/07

Tavistock Avenue (12) 26/04/06

Tavistock Avenue (12) 18/08/05

Tavistock Avenue (12) 21/01/05

Tavistock Avenue (12) 20/10/04

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 Tavistock Avenue (12) 12 Tavistock Avenue St Albans Hertfordshire AL1 2NH Lead Inspector Mrs Jan Sheppard Unannounced Inspection 12.45 25 January 2006 th Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tavistock Avenue (12) Address 12 Tavistock Avenue St Albans Hertfordshire AL1 2NH 01727 850 215 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) Cherry Tree Housing Association Mrs Janet Gale Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2005 Brief Description of the Service: The home, known as 12 Tavistock Avenue is a semi-detached house in a quiet residential area of St. Albans. It is situated close to local amenities and provides personal care and accommodation for three people. These residents have their individual single bedrooms and share the lounge, dining room, bathroom and laundry room. There is a pleasant domestic style kitchen that overlooks the secluded rear garden and patio area. Staff have a small office and sleeping accommodation on the first floor. There are small gardens with off street parking to the front of the property. The home, which is run by Cherry Tree Housing Association, offers homely and safe accommodation and full care services for its residents who all have learning disabilities. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The homes new manager is Ms. Janet Dean; she is not yet registered with the Commission. This was the second unannounced inspection of this inspection year and took place over one half day when all the residents and the staff on duty were spoken with, records examined and a tour of the building undertaken. The comments in this report reflect the findings made by the inspector during that time and also take account of information gathered from residents relatives and from the pre-inspection questionnaire recently completed by the homes manager. Not all of the standards were examined during this inspection as they were all covered during the previous inspection, on 18th August 2005, to which reference may be made. Number 12 Tavistock Avenue continues to offer a caring and homely environment for its residents. however it was noted that the relaxed and harmonious atmosphere that had always previously been a feature of the home was, on the day of this inspection, no longer evident. The requirements are made following the previous inspection have been met or are in the process of being met. Three requirements are made following this inspection. What the service does well: What has improved since the last inspection? Since the last inspection a number of works of redecoration and refurbishment have been carried out internally in the home and these have enhanced the facilities and appearance considerably. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 the following standard(s): 2,4 and 5 The home has policies and procedures relating to the care needs assessment and the visiting to the home by prospective service users that meet the requirements of these standards but these were not fully followed for the most recent new admission to the home. EVIDENCE: Since the last inspection one new resident has been admitted to the home. This admission was made to meet the emergency situation of the prospective resident but unfortunately neither an adequate assessment of his care needs or sufficient visits to the home to meet the existing residents were arranged prior to his admission. On the day of this inspection the placement had still not been formally agreed as a permanent. The new resident and the existing residents in the home do not get on and being a very small home this is causing considerable problems. The manager and the Director of Care discussed with the inspector how they were trying to resolve this matter so that the best interests of all the residents would be assured. Requirements are made. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 the following standard(s): 6 and 8 Personal care and assistance offered to the service users is of a high standard and is delivered in a manner that retains their dignity and respect. Service users are given every encouragement to make as many decisions about their own lives as it is safely possible for them to do. Standard 6 is not fully met see standard 2 for requirements concerning this. EVIDENCE: The home’s records were found to be securely kept in locked cabinets in the homes office. Staff demonstrated a good awareness of confidentiality, which in this small homely house is not always easy. The care plans for the two permanent residents were found to be well maintained with good detail as to how care needs should best be met and up to date information and risk assessments concerning their changing needs. Evidence of the residents own contributions to these care plans could be seen. The care plan for the new temporary resident was noticeably less full with fewer details or risk assessment. The staff explained that because of the lack of a full initial care needs assessment and lack of information concerning medical needs they had found it difficult to compile a current care plan and were mostly working to the plan that had been used at his last placement. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 10 However the senior care said that as they were getting to gain the residents confidence they were gradually building better information and to assist them a consultation with a medical Consultant had been arranged. Staff said that following recent press publicity and other events they had become much more aware of the necessity to assist residents gain a better understanding of the need for good nutrition and the importance of using fresh ingredients. To assist them with this the home had decided to only use preprepared ready meals very occasionally. The activity programmes for the two residents have been reviewed since the last inspection so as to better meet their needs and changing abilities. One resident told the inspector how much he is enjoying his new college classes and the fact that he is now able to make his journey to college on the bus independently accompanied only by another student who lives locally. It is a requirement that an activity programme for the new resident involving activities both internal and external to the home is established and appropriately recorded. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 the following standard(s): 12,14 and 17. The home’s two permanent residents have an individually planned activity and educational programme arranged to meet their needs and promote their skills and interests. The third resident currently has no activity programme. The home provides a nutritious and varied menu chosen by the residents and supervised by a dietician, which offers fresh ingredients and home cooking on a daily basis. EVIDENCE: There have been no major changes to the arrangements concerning the provision of meals since the last inspection. All the residents participate in choosing their weekly menu and some residents assist with the purchasing and with the preparation of the food. On the day of this inspection one resident was seen to be assisting a member of staff with making a fat free cake for their tea. Residents arriving home from their day activities were seen to help themselves to yogurt from the fridge and fruit from the fruit bowl as an afternoon snack. Staff told the inspector that they were helping the new resident on a one to one basis to develop some basis cooking skills and encouraging him to eat more healthily. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Personal care and Health care is offered to the residents in an individually planned manner so as best to meet their care needs. The home has a robust medication storage and administration system, which is well maintained. EVIDENCE: Care and assistance was seen to be being delivered in a calm and kindly manner with emphasis being given to enabling the residents to do as much for themselves as it was safely possible for them to so do. The care plans evidenced that the home maintains good working relationships between local GPs and the Community Nursing services. Referrals for specialist assessment and consultation were seen to be made as need arose. There have been no changes to the homes medication storage and administration systems since the last inspection. Currently only two residents are taking prescribed medication. The MAR, medication administration record, sheets were seen to be properly recorded and that the accuracy of these was regularly checked by the home manager. The amounts of medication received by the home and returned to the pharmacist are also regularly recorded. The home does not have a controlled drugs cupboard. No controlled drugs are currently being administered in the home. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has the required complaints policy and procedures, a copy of which has been given to all residents and where possible also to their relatives and families. The home has policies and procedures concerning Adult Protection and Whistle Blowing, which follow the guidelines given in Hertfordshire County Council Adult Protection Joint Agency procedures. EVIDENCE: There have been no incidents concerning Adult Protection since the last inspection. Staff spoken with had a sound understanding of this and confirmed that they had undertaken training about this subject. One complaint made since the last inspection was seen to have been investigated following the home’s procedures but has not yet been fully resolved. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28 and 30. Number 12 Tavistock Avenue provides a homely safe and comfortable environment where the accommodation meets the residents physical/social needs and the facilities provided are suitable to enable the appropriate care to meet their assessed needs to be given. Since the last inspection various works of redecoration and refurbishment have improved the overall internal appearance of the home. EVIDENCE: The home which fits unobtrusively into its local community appearing like any other semi detached house in the road, provides sufficient space and facilities to meet the needs of the current residents. The single bedrooms are adequately furnished in a style which reflects the residents tastes and with furnishings and equipment that meet their needs and enable them to further their hobbies and interests. None of the bedrooms has an individual washbasin. The recently refurbished bathroom has a greatly improved modernised appearance and this and the benefits of its new power shower were explained to the inspector by one of the residents. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 15 New soft furnishings, cushions and throws in the lounge, along with the new TV Video and DVD player have improved the appearance and comfort of this room. Works of redecoration to cover the damage caused by the leaking pipes has been completed in the kitchen. Redecorations are required in the hallway and up the stairs where the walls are badly marked and scuffed and it a requirement that the partial works of redecoration to the walls of one residents bedroom are completed. Repairs are also needed to the broken picket fence enclosing the front garden. (See requirements for standard 24). One requirement from the previous inspection concerning the need to regulate the excessive heat in one residents bedroom (this requirement has a with a completed action date of April 2006) has not yet been met. On the day of this unannounced inspection the home was found to be clean and tidy with no unhygienic odours. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36. The home has the appropriate recruitment policies and procedures. It is fully staffed with experienced and well qualified carers who work well together as a team to meet the care needs of the residents. EVIDENCE: The care staff group is very stable and there have been no changes since the last inspection. It was not therefore possible to examine the homes recent recruitment records. The home offers very good training opportunities with carers having attended courses on medication administration, first aid, sexuality in learning disability, epilepsy care, anti discrimination practice and food hygiene since the last inspection. All the care staff have now attained the NVQ at level 2 or are studying for this while some are also to study for NVQ at level 3. The new manager has commenced NVQ level 4 and Registered Managers award. Staff who spoke with the inspector confirmed that they receive very good support from the homes management and attend regular supervision meetings. The regular and frequent visits to the home by the Association’s Director of Care were also mentioned. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The home is generally well run with a very dedicated staff team. Close consideration to the health and welfare needs of the residents is given and this results in a warm caring environment where the residents are able to freely express their feelings wishes, likes and dislikes. EVIDENCE: All the staff spoken with said that they were happy working at the home and that they were well supported by the home’s manager. However without exception they all told the inspector that over recent weeks staff morale had dipped and they felt that the usual very good level of consultation with them by the Association had been missing. Generally there seemed to be a good level of awareness amongst the staff concerning the residents safety and this awareness was also demonstrated by the residents. One, (whilst in talking with the inspector about the unaccompanied journeys he now makes to the shops and on the bus to attend college), constantly mentioned the precautionary actions that he takes to ensure his own safety. Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 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 x 2 x 2 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 LIFESTYLES Standard No Score 11 x 12 2 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tavistock Avenue (12) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x DS0000019562.V270394.R01.S.doc Version 5.0 Page 19 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 YA4 Regulation 15 Requirement It is a requirement that all new residents have a contract of terms and conditions and have a new care plan and risk assessments compiled by the home’s staff. It is a requirement that prospective new residents have their care needs fully assessed and are able to visit the home to meet with the existing residents before admission is arranged. It is a requirement that the incomplete decorations in one residents bedroom are completed. That the scuffed walls on the stairs are repainted and That the broken picket fence around the front garden is repaired. Air conditioning, or some other remedial measure must be taken to ensure that the heating levels in one residents bedroom (next to the boiler house), do not become too high. This requirement is continued from the last inspection but remains within the prescribed DS0000019562.V270394.R01.S.doc Timescale for action 28/02/06 2 YA2and YA4 14(1)& (2) 28/02/06 3 YA24 23(2)(d) 31/03/06 4 YA24 23(2)(b) 30/04/06 Tavistock Avenue (12) Version 5.0 Page 20 time limit. 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 Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Tavistock Avenue (12) DS0000019562.V270394.R01.S.doc Version 5.0 Page 22 - 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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