Inspection on 17/10/05 for The Avenue (44)

This inspection was carried out on 17th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Avenue (44) 12/07/07

The Avenue (44) 17/07/06

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 44 The Avenue 44 The Avenue Watford Hertfordshire WD17 4NS Lead Inspector Sheila Knopp Unannounced 17 October 2005 15:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 44 The Avenue Address 44 The Avenue Watford Hertfordshire WD17 4NS 01923 226946 01923 212546 CareTech Community Services (No.2) Ltd www.caretech-uk.com Keith Parkes Care Home 8 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Learning Disability (LD) - 7 registration, with number Learning Disability over 65 - 1 of places 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 April 2005 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. 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, larger rear garden and off-road parking. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second of two planned inspection for the year from April 2005 – March 2006. Standards not covered in this report were inspected earlier in the year and can be found in the inspection report dated 4 April 2005. This report reflects the observations made in the home at the time of this unannounced inspection. The inspector met with all the service users and the three staff on duty. Care records relating to risk assessments and leisure activities were reviewed. The accident and incident records were checked to identify any issues arising between inspections. Prior to this inspection the Commission received positive feedback from 2 relatives in regular contact with the home. The following comments were made – ‘Keith Parkes is the best manager we have ever had and all staff are always helpful and very nice people’. No concerns have been raised with the Commission by relatives or other health and social care workers between inspections. Including preparation time 5 hours have been allocated to this inspection. What the service does well: What has improved since the last inspection? There has been a marked reduction in incidents, self-harming behaviour such as head banging and scratching and episodes of challenging behaviour. Positive work by staff in the home and the gradual introduction of an outreach service for one of the service users had had a very positive effect on their quality of life. For the first time in three years the stability of the management and staff group within the home has enabled service users to have a holiday. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 6 Care Tech appear to be giving the manager more control over decisions which have implications for the budget but also enable a more responsive approach to the situation within the home, for example having carpets cleaned. The flooring in the kitchen has been replaced and a much needed new carpet has been provided in one of the bedrooms. It is hoped that this approach will be extended to enabling the manager to have the resident’s bedrooms decorated while they are on holiday next year. The bathrooms, corridors and stairs were being decorated at the time of 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. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 standard(s) These standards were not assessed. There have been no admissions to the home since 1994. Although 44 The Avenue is registered to accommodate 8 residents 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 over 65 years of age and this is reflected on the certificate. EVIDENCE: 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 The key worker and care planning systems in place support the rights of service users to be involved in making choices about their lives. The well-being and safety of service users in the home and while out in the community are supported by risk assessments. EVIDENCE: Discussions with the manager and staff provided evidence that residents and their representatives are consulted and involved in making choices according to their level of understanding and involvement. Individual care plans are person centred and based on the knowledge that relatives, staff and day care services have gathered through observing the responses of service users to different situations and experiences. A new system for recording the one to one interaction between service users and their key worker and identifying communication needs more clearly has been recently introduced by Care Tech. The ‘Talk Time’ guidance requires staff to demonstrate how decisions affecting the service user have been reached. As part of a renewed focus on the communication needs of service users staff have received some Makaton training. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 10 The manager recognises this will need to be reinforced with further updates to enable staff to develop their skills. The manager reported that it has been identified that some of the residents have the ability to use Makaton to a greater extent than previously identified. The activities that service users engage in both within the home and in the wider community are supported by risk assessments. The assessments cover health and behavioural related issues with supporting information for staff on triggers that may indicate preventative measures are needed to avoid problems. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 & 16 With the support of staff service users have the opportunity to take part in appropriate community activities, which reflect identified interests. Staff provide support to service users in maintaining links with family and friends. EVIDENCE: All residents have an individual programme of day care activities and planned time at home for activities such shopping and managing their money. Individual residents go out during the evening and at weekends with the support of staff who have use of a car. The inspector sat with two residents looking at pictures of their summer holiday. This provided evidence of service users being involved in activities appropriate to their age and health status. The day care services within the local area have undergone major changes in the last year resulting in service users attending new services. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 12 Staff have developed good links with these new services to identify how the needs of service users can be most appropriately met and day to changes or concerns can be communicated. Examples were identified where staff are helping to support service users who spend time with relatives at the weekend. It was reported that copies of holiday photographs have been sent to family members. Service users are encouraged to take part in the day to day running of the home and take responsibility in relation to managing their laundry and organisation and cleaning of their rooms. One service user particularly enjoys helping prepare meals and packed lunches. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected. EVIDENCE: Under standard 20 staff are now recording the temperature of the medicines storage area to ensure stocks are stored appropriately and recording the dates of opening on packs of medicines so that amounts given can be audited against the records if required. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The welfare and protection of service users is supported by Care Tech policies and procedures, reporting and investigation of incidents and supervision of staff. EVIDENCE: A member of staff confirmed they were able to raise issues and question practice as part of their supervision sessions and that they were not uncomfortable or concerned about practices within the home. Staff receive Protection of Vulnerable Adult training at part of their induction and foundation training. The Hertfordshire multi-agency procedure was available to staff. To ensure that all staff remain aware of their responsibilities in this area it has been recommended that staff who have not had recent training receive updates. No issues of concern were identified from the incident and accident records examined. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The home was found to be fresh and clean. There are suitable systems in place to prevent cross infection and manage resident’s laundry hygienically. EVIDENCE: Staff and residents have access to a washing machine with a sluice cycle. Staff have access to liquid soap, gloves and disposable bags and aprons. Staff are advised to have Hepatitis B vaccinations as part of their initial health screening. The manager recently attended an infection control training session by the Hertfordshire Infection Control nurses. The kitchen would benefit from a refit to maintain standards as the work surface and tiling over the sink in the kitchen need to be replaced and the remaining work surfaces and cupboards are beginning to look worn. The fixtures, fittings and tiling in the bathrooms are also looking rather worn and very functional. Care Tech should consider upgrading these areas in their maintenance plan for the home. Over-ride locks have been provided on the bathroom and toilet doors to enable residents to lock them if they wish. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected EVIDENCE: 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected EVIDENCE: Under standard 39 it has been previously recommended that the views of service users, relatives and stakeholders such as social workers and community health workers are included in the quality assurance report. The manager reported that the company sends out questionnaires but this information is not currently part the feedback received by the home. However it was reported that a new quality assurance reporting system is being introduced. It is hoped that this area has been considered. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 44 The Avenue Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 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 Regulation None 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. 3. 4. 5. 6. Refer to Standard 23 23 24 24 24 37 Good Practice Recommendations Identify frequency of POVA training updates for all staff. Manager to consider attending Hertforshire County Council training on multi-agancy policy as update. Programme flexibility into the maintnence and renewal plan for next year to enable the manager to have the bedrooms decorated while the residents are on holiday. Provide CSCI with a programme to upgrade the kitchen and replace the damaged work surface and tiling by the sink. Provide CSCI with a programe to upgrade the bathroom fixtures fittings and tiling. The manager has agreed to update CSCI on succesful completion of the final module of the Registered Managers Award. 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City 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 44 The Avenue I52 s65463 44 the avenue v248678 171005 stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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