Inspection on 16/02/06 for The Avenue

This inspection was carried out on 16th February 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 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

The Avenue 12/04/07

The Avenue 22/06/05

The Avenue 15/12/04

The Avenue 03/06/04

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 The Avenue 72 Bates Avenue Cockerton Darlington County Durham DL3 0TU Lead Inspector Rachel Dean 16 th Unannounced Inspection February 2006 10:30 The Avenue DS0000000783.V273188.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 The Avenue DS0000000783.V273188.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. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Avenue Address 72 Bates Avenue Cockerton Darlington County Durham DL3 0TU 01325 240452 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) john.leitch@tesco.net Mr John Michael Leitch Miss Sharon Elizabeth Keelan Miss Sharon Elizabeth Keelan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: The Avenue is a care home that provides personal care and accommodation for three adults who are aged between eighteen and sixty-five years old and have learning disabilities. The Avenue is privately owned and is run by Mr. John Leitch & Ms. Sharon Keelan. The home is a semi-detached property that is located in a residential area of the Cockerton district, Darlington. Each service user has their own spacious bedroom and communal space includes a large combined lounge and dining room, a kitchen diner, upstairs bathroom and staff office, car parking in front of the property and a small courtyard garden at the back. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, which took place on 16th February 2006. During the inspection the inspector spent time with the three service users who live in the home, the home’s manager and two other members of staff. A selection of the home’s written records were also inspected. This inspection focused on how people are admitted to the home, the care records that are kept by the home, the health and personal care provided, how medication is managed, how people are treated, the daily activities and routines in the home, the meals that are provided and how complaints are handled. What the service does well: What has improved since the last inspection? What they could do better: Overall the support and care provided at the Avenue is of a high standard. During this inspection a small number of areas for improvement have been identified, but these are good practice recommendations rather than legal requirements. These recommendations include ways of making the medication system less confusing and looking for alternatives to the currently invasive method of administering some medication. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Avenue DS0000000783.V273188.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 The Avenue DS0000000783.V273188.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 The people who live in the home were assessed before admission and were admitted to the home in an appropriate way. EVIDENCE: The Avenue currently has three people living there. These three people have lived at the home since it was set up approximately thirteen years ago and there are no plans for them to leave or for anyone else to be admitted. The three current residents were admitted appropriately when the home was opened, with their needs being assessed and the home being set up accordingly. The Avenue DS0000000783.V273188.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, 7 & 9 Each of the three people who live in the home has their own care plan and record of care. Staff help the three people living at The Avenue to make decisions about their own lives. The people living in the home are supported to have as independent a lifestyle as possible, according to their individual wishes and abilities. EVIDENCE: During this inspection a selection of the care records that are kept by the home were inspected. Each person living in the home has their own care plan, which is well organised and includes detailed information about their needs and preferred routines of daily living. Risk assessments were also in place. The records included regular monthly reviews and daily and monthly reports. Two of the people living in the home had chosen to complete a person centred plan. These were inspected and found to contain detailed information about each person’s wishes and feelings, including photographs and information about their aspirations for the future. One person had not wished to contribute to a The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 10 person centred plan and their social worker had confirmed that this was the person’s choice in their records. Discussions with the home’s staff and observations made during the inspection indicated that the home is run around the individual wishes of the three people who live there. Staffing are put on duty according to the needs of the residents and the activities they are taking part in. For example, if someone is going to a party that doesn’t finish until midnight, staff are put on duty until the party finishes, rather that the service user having to leave the party early to accommodate the finishing time of a particular shift. The home had in place good risk assessment and management systems to help identify what support people needed to live a fulfilling life and to help them achieve their goals. The home’s approach was very person centred, with goals identified according to each individual’s own personal abilities and wishes. For example, one person wanted to fly in an aeroplane and the manager was in the process of planning ways to make this possible. This included using a short domestic flight for the person’s first flight, where alternative return journeys by train or car could be arranged if necessary. Other good examples of this were available, including how the home sensitively helped one of the people living in the home to manage a complex health issue and were supporting another to safely make their own cup of tea. The Avenue DS0000000783.V273188.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, 13, 15, 16 & 17 The people living at The Avenue are supported to develop new skills and experiences, in accordance with their own wishes and individual abilities. The home supports the people who live there to take part in the local community and use local resources, like the local clubs, shops, pubs, public transport and leisure facilities. The staff enable and encourage the people living in the home to have appropriate personal relationships with family and friends. The rights of the people living in the home are respected by the staff. A varied menu has been developed and this takes account of the needs and preferences of the people living in the home and is flexible to accommodate their lifestyles. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 12 EVIDENCE: All of the people living at The Avenue have day centre placements or arrangements for social stimulation that have been arranged by the local authority and are part of their care plan. These placements provide access to training courses for those people who want and are able to do them. They also provide opportunities for suitable social activity, one to one staff support and work placements where these are appropriate. The staff working in the home help the people living there to use local community resources as much as possible. All of the residents enjoy an active social life, including use of public transport, leisure centres, pubs, parks, football matches, beauty therapy and at least two holidays a year away from the home. These holidays are taken either together or individually depending on what they want to do and where they want to go. One of the people living in the home was able to show the inspector where they had been and where they were going in holiday brochures and photos of outings and holidays had been used in people’s person centred plans. The home encourages the involvement of family and friends and often has the friends and family of residents visiting the home. Where no family are involved the home encourages regular visits from the person’s social worker. The people living at the home have a busy social life and often have friends calling for visits and meals, meeting up to go on outings together, visiting each other for parties or simply socialising together. During the inspection discussions with staff, care records and observations showed that the people living in the home are encouraged to join in with tasks such as making drinks and other domestic arrangements. For example, one person has two guinea pigs which staff help and support him to look after. The people living in the home are also encouraged to join with household tasks, such as being present and helping as much as possible when their bedrooms are tidied. The home has two pleasant dining areas, one located in the kitchen and a more formal one located in the large lounge/dining room. All of the staff employed at the home have completed food hygiene training. Menus are drawn up on a weekly basis, but because of the service users busy lifestyles these are used as a flexible guide. The menus are frequently changed to accommodate what people want and the outings that they are involved in, which often include eating out. The people living in the home are encouraged by staff to help and participate in the preparation of meals as much as their personal abilities allow. For example, from putting their plate away, helping make a drink or prepare food, to cooking simple meals with staff supervision. A record of what each service user had eaten for breakfast, lunch and dinner on each day was available. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 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 the following standard(s): 18, 19 & 20 Assistance with personal care is provided in a way that is appropriate for each individual person living in the home. The emotional and physical health needs of the people living in the home are met by the home’s staff and by the involvement of other professionals where this is appropriate. Assistance with medication is provided to service users in an appropriate and safe way. EVIDENCE: All three of the people living at the home need help with their personal care. Discussions with the home’s manager, staff and observations of the way staff interacted with the service users showed that assistance is provided in sensitive and caring ways. All of the people living in the home appeared to be clean, nicely and appropriately dressed and appeared comfortable in their surroundings. Good information about each person’s personal care needs was available in their individual care plans and records. There was also evidence of special equipment, such as equipment to help people eat independently, being used. There was evidence of the involvement of other professionals, like occupational therapists and physiotherapists, where this was appropriate. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 14 Each of the people living at The Avenue is registered with their own doctor and the home uses two different doctor’s practices. The residents are also registered with opticians and dentists, with each service user being registered with the service that is most appropriate for them depending on their past experience or needs. For example, one person is still registered with the dentist they had while in hospital, because they know each other well. Records were available of all appointments and health checks. Only two of the people living in the home were on medication at the time of this inspection and both needed fully support with this. Medication was being appropriately stored in a lockable metal cupboard and records were available of all the medication that was taken. All of the home’s staff have completed training on ‘the safe handling of medication’. The home uses a medication system supplied by ‘Boots’. However the medication supply cycle was not synchronised with the recording system and it is recommended that this is discussed with the supplier to try and make the system less confusing. It is also recommended that the current prescription for an invasively administered medicine be reviewed, to see if a less invasive alternative is available. If an alternative is not available it is recommended that all staff receive regular up date training in the administration of this medicine, to ensure that all staff are competent to carry out this procedure in a safe and appropriate way at all times. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 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 the following standard(s): 22 The views of the people living in the home and their supporters are listened to and acted on. The remaining key standard (23) was not assessed during this inspection. It was assessed during the last inspection and only outstanding issues were followed up during this visit. EVIDENCE: The home has in place a formal complaints procedure and records of complaints. However, there have been no recent complaints made either directly to the home or to the CSCI. Any simple day-to-day concerns are dealt with immediately by the home’s staff or manager. It is recommended that the Disciplinary and Abuse procedures are crossreferenced with the Department of Healths POVA list guidance, to ensure that any appropriate staff are referred to the list properly. This recommendation remains outstanding from the last inspection. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 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 the following standard(s): These key standards were not assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this visit. EVIDENCE: The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Service users are supported by competent and well qualified staff. The remaining key standards (34 & 35) were not assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this visit. EVIDENCE: The staff at The Avenue continue to be well training. All seven care staff have achieved at least a level two National Vocational Qualification (NVQ) in Care. The registered manager has achieved the Registered Managers Award and a level four NVQ in Care. The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These key standards were not assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this visit. EVIDENCE: The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 19 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 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Avenue Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000000783.V273188.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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 YA20 YA20 Good Practice Recommendations The medication supply cycle was not synchronised with the recording system and it is recommended that this is discussed with the supplier to try and simplify things. It is also recommended that the current prescription for an invasively administered medicine is reviewed to see if a less invasive alternative is available. If an alternative is not available it is recommended that all staff receive regular up date training in the administration of this medicine to ensure that all staff are competent to carry out this procedure in a safe and appropriate way at all times. It is recommended that the Disciplinary and Abuse procedures are cross-referenced with the Department of Healths POVA list guidance, to ensure that any appropriate staff are referred to the list properly. This recommendation is outstanding from the last inspection. 3 YA23 The Avenue DS0000000783.V273188.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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