Inspection on 31/08/06 for Tomlinson Avenue

This inspection was carried out on 31st August 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tomlinson Avenue 13/12/05

Tomlinson Avenue 05/06/05

Tomlinson Avenue 17/01/05

Tomlinson Avenue 10/09/04

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 Tomlinson Avenue Respite Service 96 Tomlinson Avenue Luton Beds LU4 0QP Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 31st August 2006 3:15 Tomlinson Avenue DS0000061246.V307825.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 Tomlinson Avenue DS0000061246.V307825.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. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tomlinson Avenue Address Respite Service 96 Tomlinson Avenue Luton Beds LU4 0QP 01582 605196 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) Luton Borough Council Fiona Dwyer Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No. of residents: 4 Gender: Male & Female Category: Learning Disability Period of Stay: Respite (max 4 weeks stay) Current respite service users who are over 65 years of age may continue to receive a service from the home, as long as their needs are being met. No new service users over 65 years of age may be admitted to the home without prior consultation with the CSCI. Evidence that the service meets the requirements of the local Environmental Health Department must be forwarded to CSCI within one month of opening. 6. Date of last inspection Brief Description of the Service: Tomlinson Avenue is a fully refurbished and extended detached house, which provides a respite service for up to 4 adults with learning disabilities at any one time. It is located in Luton, in the middle of a busy residential area with many local amenities. There is a bus stop directly outside the home, which provides a regular service to Luton and Dunstable. It is not intended that the home will accommodate people with a physical disability however; it can accommodate people who require the use of a wheelchair on occasions. The accommodation was arranged on two levels and consisted of 2 single bedrooms on each floor. Shared space included a bathroom and separate toilet on the first floor, on the ground floor there was a disabled access shower and toilet, kitchen, laundry room, lounge and conservatory. Individual and communal rooms had been decorated to a high standard and were well equipped with regard to furnishings, fabrics and entertainment systems. A staff office/sleeping in room was on the first floor. There was an enclosed garden with ramped access for wheelchair users, and parking space for a small number of cars. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an unannounced inspection that took place at 3.15pm on 31.08.06 over 3 hours by Pursotamraj Hirekar. The support workers on duty coordinated the inspection. The methods of inspection-included study of service users care documents, talking with service users and their parents, home safety and environment checks documents and tour of the home. What the service does well: 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. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 6 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 Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 7 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide enabled potential service users to make informed decisions. EVIDENCE: On this inspection 2 new service users’ were case tracked and found that both the service users’ had prior information and an opportunity to test drive the home to make an informed choice that the home they choose will meet their needs and aspirations. Service user-1 potential client assessment was dated 28/7/6, assessed for tea visits, short term to enable mum to escort dad to hospital appointments. Service user’s mother said the service user liked this place. First tea visits with mum was on 31/7/6 and today was the third tea visit eventually the service user may plan to sleep over for night. Currently visiting for tea visits. Risk assessment was done on 22/8/6 that includes falls/trips/slips, road safety and community awareness. Service user - 2 assessment for potential client was dated 13/08/06, signed by the manager and a copy of the statement of purpose, service users guide and how to make a complaint /comment was given on 13/08/06. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 8 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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had made comprehensive needs assessment and had developed detailed care plans of service users’ which were implemented as planned. However, service user –4 care plan review and revised careplan was outstanding. EVIDENCE: On this inspection 4 service users’ were case tracked and their details are as follows: Service user – 1 community care assessment was done on 21/03/06 and service user –2 was done on 17/03/06 details included reason for referral, service users view and wishes, carer view and wishes, current level of functioning, support currently received by, health care needs and services, housing and accommodation issues, culture and personal history, financial benefits, how to increase the independence of service user, deterioration, how to help carers, carers assessment was done on 26/04/06, objectives included, services proposed to meet identified needs, health and safety issues, review date was due on 23/06/06. Any one person including team leader, team manager, commissioning worker and service user, did not sign the assessment. Service user –1 and 2 assessment details included medical and health, eye sight, GP, psychologist, current medication, medical history, medical condition, self-help skills, personal care, meal times, cooking, washing Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 9 and ironing, general house keeping, communication, level of understanding, relationships, community integration, road safety skills, monetary skills, like and dislikes, religious needs, day activities, finances, hobbies, general likes and dislikes. Service user – 3 contract detailed rules, respect for others, activities, personal hygiene, meal and meal timings, breakages, valuables, and fees. Care plan prepared on 23/02/06 that included care services – family and care support, day care services at bramingham centre, respite care, social worker support reviews, community nurse support and advice. Date for next review was February 2007. However, the service user or representative has not signed the care plan and was signed by the team manager only. Service user –4 support plan was dated 23/10/03, reviewed on 19/11/04 and no changes were made, again reviewed on 18/11/05 no changes were made to the care plan. The service user was diagnosed with Down syndrome with moderate learning disability. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 10 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had consultations with all service users’ individually and developed activites that meet the individual service users’ needs and aspirations to achieve quality of life goals. EVIDENCE: The home had made appropriate arrangements to facilitate the overall personality development of the service users, through various stimulating activities. The activities include walk to shops, pub, pool and park. The service users expressed their happiness with the range of activities they had participated. The food menu was prepared in consultations with the service users. The service users were satisfied with their choices and variety of food they were offered. The service users those were spoken to, meet their friends and family members regularly and have good relationships. Service user –1 attends day care centre 5 days per week. Service users’ personal property list of items was maintained and signed by staff member. Support plan include eating and drinking, washing and dressing, sleeping, leisure. Service user –2 Care plan was dated 18/7/2001, that included information on care services for bramingham centre, social services and waluds house respite unit to visit once Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 11 a month. Daily log sheet maintained. The staff managed finances and a record was maintained. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed personal and health care needs of the service users’ were met as per the care plan. EVIDENCE: The home had developed a good system of physical and emotional health needs assessment. The action plans were prepared taking into account the results of the need assessments. The action plans implementation was monitored regularly. Service user –1 risk assessment was dated 22/07/05 and due for review on 22/07/06 that included kitchen, money, bath and shower and accessing the community. Manual handling risk assessment was dated 05/08/05 and was due for review on 05/08/06. Hazard checklist was dated 22/07/05. Medical report dated 11/04/06 recommended medication. Medication record and daily log sheet was maintained. Service user –2 Support plan included support for communication and emotional support, skills and abilities, significant risks, support required for personal care, likes and dislikes, support for washing and bathing, support for eating and drinking, support for mobility, support for toilet, managing finances. Service user –3 Care reviewed on 23/02/06 that included summary of present services, objectives of current plan, views of service user, views of relatives/carer, views of care providers/other professionals, health and wellbeing of service user, access to community services, reassessment of need Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 13 since last review, standard of service received, extent to which the objectives and outcomes have been met, new objectives and preferred outcomes, actions agreed, health and safety. Signed by the team manager only. Date sent to the customer/service user was blank. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their family members were happy with the services the home provided. EVIDENCE: The service users, their relatives and their representatives have held that their views were listened to and acted on and they do not have any complaints. The service users were satisfied with the services and facilities the home was providing, as they perceived to be in their best interest. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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 the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements for service users’ to live in a homely, comfortable and safe environment and was maintained without any offensive odours. EVIDENCE: The tour of the home to the kitchen, utility and laundry room, toilets, shower room, bed rooms, office – cum sleep in room, conservatory were found to be clean, hygienic and nicely decorated to meet the choices and taste of the service users. Water temperature of bath and wash hand basin temperature were recorded on 02/08/06. Fire risk assessment was reviewed on 03/01/05. Waking night fire check record was maintained and Fire drill was carried out on 23/07/06 and 23/06/06 and emergency lighting on 01/07/06 and 01/08/06. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good skill mix of staff that complemented with team work. EVIDENCE: The staffs have appropriate skills to meet the needs of the service users under the guidance of the manager. The manager was on leave on this inspection and the support staffs coordinated the entire inspection. The support staffs did not have access to the personnel records for verification. Discussions were held with 2 staffs on duty the details are as follows: Staff member-1 working as support worker since January 2004, qualification include LDAF, access to higher education in health and social care, doing NVQ3 in care. Trainings undertaken included moving and handling, food and hygiene, infection control, risk assessments, cosh, choking and swallowing, team-teach, fire training and pova. The staff member did not have any suggestion for improvement. Staff member - 2 working since a year as support worker, responsibility included support clients, with cooking, toileting, wash, shopping, washing clothing, emotional support, keep there privacy, administration of medication, take them out to meet their social needs. Qualification had LDAF, NVQ2, trainings undertaken team-teach, health and safety. The staff member did not make any suggestions for improvement and said that the service here is fantastic and service users’ have their choice s for everything. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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, 39 and 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The manager and the staffs work as a team in the interest of service users’. EVIDENCE: The service users and their parents spoken to have expressed their happiness with the services and care the home was providing. The parents of a service user have said that they were very pleased with the services. The service user said that the staffs were very good and committed. The home was managed well even in the absence of the manager. The staffs and the service users’ have good working relations and the staffs’ work in accordance with the support plan of the service users’. Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 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 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 3 X 3 X 3 X X 3 X Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 (2) Requirement Timescale for action 15/10/06 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 Tomlinson Avenue DS0000061246.V307825.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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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