Inspection on 12/07/07 for The Avenue (44)

This inspection was carried out on 12th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Avenue (44) 17/07/06

The Avenue (44) 17/10/05

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 The Avenue (44) 44 The Avenue Watford Hertfordshire WD17 4NS Lead Inspector Mrs Jan Sheppard Key Unannounced Inspection 12th July 2007 9.45 The Avenue (44) DS0000065463.V345815.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 The Avenue (44) DS0000065463.V345815.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. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Avenue (44) Address 44 The Avenue Watford Hertfordshire WD17 4NS 01923 226946 01923 212546 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) CareTech Community Services (No.2) Ltd New Manager Jason Cox application for Registration in process Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th July 2006 Brief Description of the Service: 44 The Avenue is a large detached house, located close to the centre of Watford. The registered provider is Caretech Community Services Ltd. The home provides care and services in a safe environment for 8 residents who all have learning disabilities. On the ground floor there is an entrance hall, lounge, three single bedrooms, bathroom with toilet, kitchen, dining room and a utility room. There are five single occupancy bedrooms on the first floor, a bathroom and two separate toilets. There is also a second floor that is used to provide an office, sleep-in accommodation, bathroom and kitchen. The second floor is used exclusively by staff. There is a small front garden, a larger rear garden that is secure and offroad parking. The Statement of Purpose and Service Users Guide provide information about this home and these documents along with the Complaints Policy and Procedures and a copy of the last Inspection Report are available in the homes entrance hallway. The fees, which are determined according to the level of care, range from £879 per week. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day when one inspector spent six and a half hours visiting the home speaking with the manager, all the staff on duty and also speaking or otherwise communicating with all the seven residents. A tour of the premises was also made with the homes manager. The comments in this report reflect the findings made during that visit and also take account of information sent periodically to the Commission by the manager and other information from relatives and stakeholders in the home. The afternoon routine of the home when the residents returned from their day activities was observed and a number of key records were spot-checked. This was a positive inspection the residents were all well, and looked happy and well cared for. Improvements noted at the last inspection had been maintained and consolidated and further improvements have been made. The home had a well-ordered and homely atmosphere where staff and residents were seen to be interacting positively together. The majority of the key standards inspected were met and the requirements and recommendations from the last inspection had been met or are in the process of being met. Two requirements and one recommendation are made following this inspection. What the service does well: This small home provides a very individualised caring service for its residents in a homely and safe environment. Many of the staff are long standing and have developed a very detailed understanding of how best to meet the care needs of each individual resident, constantly working towards enabling them to move away from their former institutionalised patterns of living. Despite the residents’ lack of ability for verbal communication the staff consult very thoroughly with them using varying strategies during their weekly individual ‘talk time’ meetings. The standard of care for the residents remains good, the staff team interact well with the residents and are themselves supported with a good standard of training and management. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. Policies and procedures that meet the requirements of these standards concerning the needs assessment of new residents and appropriate visiting arrangements for their gradual introduction to the home. There is an up to date Statement of Purpose and Service Users Guide so people considering using this service can be assured of receiving up to date information. EVIDENCE: No new resident has been admitted to the home since the last inspection. The last new admission to the home was in 1994 therefore it was not possible to review any recent evidence to support these standards – although appropriate policies and procedures are in place. The new manager who had previously been a Registered Home Manager for several years in another home has had considerable experience of the assessment and admission of new residents and was able to demonstrate a sound knowledge and understanding of these standards. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 9 44 The Avenue is registered to accommodate 8 residents but there is an agreement with the funding authority to maintain the number of residents at the current level of 7. One of the service users is now over 65 years of age and this is reflected on the certificate. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 10 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 and 9. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The residents care plans are individually focussed and provide an up to date record of their needs, how these may be changing and how they will continue to be appropriately met. Comprehensive risk assessments that assist in ensuring people who use the service are kept safe are regularly reviewed to accommodate any changing ability and need. EVIDENCE: Since the last inspection the residents care plans have been rewritten following a Person Centred approach. This is an improvement on the previous format and showed better evidence of the resident’s involvement with the preparation of their plans. Picture menus and picture activity plans are being prepared to add to the individual information, which the residents can keep in their rooms. The records gave evidence of the weekly one to one ‘talk-time’ meetings that The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 11 the key workers have regularly with their residents to ensure that they are consulted and that as far as it is possible to do so (none of the residents has speech) their views are understood and acted upon. There is a robust system of risk assessment in place, which enables the residents to take reasonable risks whilst maintaining an appropriate degree of independence. One resident is able to visit local shops on their own whilst another is able to use sharp kitchen equipment whilst assisting with the preparation of vegetables; for both these activities appropriate risk assessments have been completed. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 12 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 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The diverse social and activity needs of the residents are well supported. Residents are supported, where required, to use the local community facilities. A varied and healthy diet of freshly prepared good quality food is provided. EVIDENCE: All the residents at 44 The Avenue have a very active and interesting life style according to their interests and wishes. They each have an individually planned day centre activities programme involving activities on three or four days each week with the fifth week day being spent in the home when staff will assist them to do their laundry, clean and otherwise maintain their rooms and carry out any required banking transactions. Five of the residents attend The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 13 local days centres in the Watford locality, one has their day activities organised from the home on a one to one basis by staff from the Life- Enhancers organisation. The recent changes in the pattern of day centre attendance for the seventh resident, whole day attendance reduced to half day, although being better suited to meet their changing needs remains under review with the involvement of social services and the psychology service this to ensure that their particular needs are fully met. The home continues to enable a range of evening and weekend activities to be accessed by the residents according to their choices and interests. The manager explained that since the last inspection the day activity programme offered by the local day centres has been improved so that more active and community based activities are now regularly available including two garden/allotment projects, an Out and About Club and a Drama Workshop which recently put on a show at the local Palace Theatre. The manager also said that it was his aim, over the next year, to increase and diversify the range of weekend activities offered by the home staff so as to provide a more personal and flexible service better tailored to meet individual needs and interests. The residents records evidenced that there is good liaison between the home and the local day centre staff and that regular reviews take place. Since the last inspection all the residents have enjoyed a staying away holiday and similar holiday plans to visit Cornwall have been made for them all for this year. The inspector was shown various photographs of these holidays. The residents when they arrived home from their various day activities in the mid afternoon were seen to get for themselves or to be provided with tea and an afternoon snack according to their individual wishes. None appeared to have any difficulty in making their wishes known and one resident whose low weight is closely monitored was seen to take extra portions on more than one occasion. The resident’s assist with choosing their menu on a weekly basis and some like to help the staff with the regular shopping trips to a local supermarket. One resident was found to be assisting with the vegetable preparation for the evening meal and they communicated to the inspector what the menu for that meal was to be. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 14 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 and 21. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Personal care is provided for the residents in a way that meets their needs and takes account of their own preferences and expressed choices. Residents have good access to all health services. The medication system is robust thereby generally ensuring safety for the residents. EVIDENCE: Care plans were seen to include full details of the care needs of the residents and how these should be met in ways that the residents prefer. Staff explained to the inspector about the very detailed understanding of the resident’s wishes that they had built up through visual means to ensure that their care could be delivered smoothly. 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 do. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 15 The care plans gave ample evidence of the involvement in the residents care of a range of health professionals. Since the last inspection one resident who needed a period of hospitalisation and a small operation was continually accompanied whilst in the hospital by a member of staff and a letter of appreciation from their relative for this gesture was shown to the inspector. The manager confirmed that currently all the residents are well with no on going major health problems and that currently the home is not requiring the services of any regular visiting health professionals. The residents have easy access to local community dental services and each has a bi annual optical assessment. As the residents age the possible need for regular hearing assessments was discussed with the manager. He mentioned the recent withdrawal of both the free chiropody service and the regular visits from the Dietician service and told the inspector of the various ways in which he was trying to remedy these shortfalls. His recent meeting with the Incontinence advisor was mentioned as being positive and continues the already established links with this service. The home continues to use the MDS - Monitored dosage system medication storage and administration system provided by a local chemist. Staff who administer medication have received appropriate training. Spot checks of the medication administration records made on the day of this inspection found these to be accurately maintained. A management system for checking these records could be evidenced. Two recent lapses with the accuracy of these records had been dealt with promptly and in such a manner so as to ensure that the safety of the residents was safeguarded. There is not currently any facilities for the storage of controlled medication. Although no controlled medication is currently being prescribed for any resident in the home this situation could change suddenly and without any warning. The manager must satisfy himself that in such an eventuality legally acceptable storage and administration arrangements could be in place in time to ensure that the required standards for the storage and administration of such controlled medication would be met. A policy, with procedures and signing arrangements for when relatives take medication from the home to administer to residents during their home staying visits is not in place. Information concerning the resident’s wishes about their care during a final illness and arrangements after death, where these can be ascertained, was recorded on their care plans. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 16 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 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Policies and procedures are in place to protect residents from abuse neglect and self-harm. Staff observe the residents (none of whom have any speech) closely so as to understand their moods and wishes. EVIDENCE: A comprehensive complaints policy and procedure is in place which is well publicised in the home and to the residents. A copy of the visual complaints policy was seen on all the residents’ files. There have been no complaints since the last inspection. A recent complimentary letter from a relative was shown to the inspector. Since the last inspection all the staff have undertaken training in the issues and procedures concerning the protection of vulnerable adults. All the staff spoken with were very aware of their role in protecting this very vulnerable group of residents none of whom have any speech and several spoke of strategies that they adopt to judge residents mood and well being. There have been no safeguarding adult issues in the home since the last inspection. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 17 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 and 30. People who use this service experience adequate quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The physical layout of the home enables the residents to live in a safe reasonably maintained and comfortable environment where their independence can be encouraged as far as it is safely possible to do this. There are some areas where better attention is required to ensure the maintenance of this environment to a consistently good standard throughout the home. EVIDENCE: This homely home is appropriately appointed so that it adequately meets the needs of its service users. On the day of this unannounced inspection the residents bedrooms were seen to be attractively decorated and very well personalised with comfortable furnishing each reflecting the individual tastes and styles of each resident. The manager explained that fresh and improved furnishings had been given to some residents but had been rejected by them and these choices were respected. However the improved furnishings in the lounge, large soft leather armchairs, were much appreciated by all the The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 18 residents and have very much improved the comfortable appearance of this communal room. The cleanliness of the home was reasonably maintained with one or two exceptions. Thick dust was noted in one bedroom and in the first floor bathroom, which also had a badly stained floor particularly the area around the WC. The manager was aware of this and explained the reasons for the recent deterioration of this area of flooring. The kitchen has still not been refurbished (a requirement was made at the last inspection), and areas of deterioration noted then have further declined since that last inspection include the broken tiles behind the sink taps. The manager explained that new furnishings had been chosen and measurements taken but said that he still did not have a firm date for these works to refit the kitchen were to be carried out. The area of broken and loose tiles to the rear of the sink taps where dirt and debris have collected now pose a considerable health hazard as does the very considerable build up of grease and dust on the cooker extractor hood. One of the two fridge freezers was found not to be consistently maintaining the required temperature, which could provide a further health hazard. It was noted that the home received only a four star rating at its last environmental health inspection on 26th March 2007. Whilst improved attention to infection control measures (use of red bags) could be evidenced at this inspection the homes small laundry would benefit from works of refurbishment and redecoration as this area too is looking very tired and has a lack shelving and other storage facilities affecting the ability of the careworkers to easily operate good infection control measures. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 19 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 and 35. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Staff in the home are experienced and trained, and have sufficient skills to support the people who use the service. There is sufficient staff to maintain the smooth running of the service. The recruitment policy and practice in place provides adequate safeguards for the residents. EVIDENCE: Staff training is given good priority in this home. All staff have a training needs profile compiled during their regular supervision and support meetings and staff told the inspector of courses that they had attended since the last inspection including - Medication, Empowerment of Residents, Fire Awareness, Epilepsy Awareness, Manual Handling and Adult Protection. There are more than fifty percent of staff holding NVQ qualifications at level 2 and several have attained or are studying for level 3. The manager is The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 20 completing the NVQ level 4 Registered Managers Award and the deputy manager holds NVQ at level 3. The recruitment records for two recently appointed new staff evidenced that the required checks had been properly carried out, this to ensure the safety of the residents. The manager explained that although staff had resigned their permanent appointments since the last inspection in fact each one had gone onto the home’s list of bank staff which meant that they still worked as and when needed at the home thereby ensuring a consistent service for the residents. This staff stability has enabled the manager to take time in recruiting permanent staff into the two vacant posts so as to ensure that the right appointment of suitably experienced careworkers can be made. All the staff spoken with said that they were well supported by the homes managers, that they attend regular supervision and support meetings and that their views and opinions are listened to; this could be evidenced by the records of the homes regular staff meetings. One support worker explained to the inspector that being a small home where staff work closely together there is always good opportunity to consult with colleagues whenever the need arises. Senior staff who carry out staff supervision have all undertaken the appropriate training for this role. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 21 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 and 42. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The home benefits from the calm and consistent approach of the experienced manager. The quality assurance system is adequate and enables the management to assess information to enable them to improve the care experience for the residents. The good record keeping promotes the health safety and welfare of the residents. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. He has a clear understanding of the key principles and focus of the service and his aim is to continually improve the quality of life for the residents and to enable them to maintain their independence. He is part way through his studies for the Registered Managers Award and his application for registration by the Commission as Manager of this home is in process. Prior to moving to this home he held the registered managers position for several years at another similar Care Tech home. Spot checks were made of various of the homes records including fire testing, accident recording, risk assessments and water temperatures and these were found to be well maintained there by ensuring the health safety and welfare of the service users. Records evidenced that staff are appropriately supervised and that a programme for annual staff appraisal is in place. The home benefits from the annual quality assurance checks made by the company. The home achieved 96 at the last Quality Assurance Audit carried out by the company in January 2007. The manager confirmed that he is well supported by the Company managers receiving regular supervision himself. Regular management visits required under Regulation 26 are made to the home and helpful comments were noted on these records. Throughout this inspection the manager demonstrated a good awareness of current good practice, national trends and recent developments in the service. He appeared to have a good understanding of equality and diversity issues and a grasp of the complexity and varying strands of these issues. It is unfortunate that despite having a computer in the home it does not have an Internet link and the manager explained that to keep fully up to date he has to use his own personal Internet connection at his home. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 x x 3 x x 3 x The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 24 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 YA30 YA24 Regulation 23(2)(b) & (d) Requirement To ensure the maintenance of good health and safety practices to protect service users the kitchen must be refurbished and maintained in a clean condition The badly stained bathroom flooring must be replaced. To ensure the safety of service users a safe system of recording the administration and safe keeping of medication by relatives when resident’s stay with them must be developed and implemented. Timescale for action 31/10/07 2. YA20 13(2) 31/08/07 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 YA20 Good Practice Recommendations The Manager should review the arrangements for the safe keeping of controlled medications. The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 The Avenue (44) DS0000065463.V345815.R01.S.doc Version 5.2 Page 26 - 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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