Care Home: 17 Norton Avenue

What the care home does well 17, Norton Avenue stands in its own grounds of a busy main road. The service is secluded from the road by a high tree screen. It provides a warm and comfortable environment in a setting suited for its purpose to provide space both communal and singular for people. People who choose to use the service have a full assessment of their needs, this assessment would involve other professional agencies where applicable. The assessment would be followed by an invitation to come to the service for the day and or to remain overnight or weekend. This enables the people to further assess the individual ensuring that their needs can be met. we were told by one person she had been to experience an over night and weekend stay prior to moving in. She told us ` I can do most things its a good place to live in`, `I like my key worker`. Arrangements were in place for the continued health monitoring and consultations from other professional agencies. People who choose to use the service were provided with a clean, well furnished, and comfortable homely single storey home. We observed the staff on duty and the staff that came to the service to act as escort to enable three individuals life style to continue. Interaction was warm positive and the people responded to the attention and help offered. Contacts throughout the day by the manager with the people were warm and she demonstrated her knowledge of the people who use the service. Documents provided for the personal care, risk assessments and social life style taken by individuals were comprehensive and included communication and health needs. We were told in the completed staff `Have your say` surveys that `the service provides a good quality care ensuring the care is tailor made for individuals`, `Care is person centered`, `I am proud to work at the home`. What has improved since the last inspection? There has been an ongoing decorating and refurbishment plan. The AQAA told us that individuals bedrooms have been redecorated and refurnished to suit individuals choice. New carpets and curtains have also been provided in the bedrooms. The dining room has been decorated and new furniture purchased. A new flat screen television has been fitted in the large lounge. We received `Have your say`,surveys completed by the people told us that the `home is also fresh and clean` Staff training has included challenging behaviour and the management of potential aggression courses. Since the last inspection the complaints procedure has been reviewed. What the care home could do better: During the inspection it was noted that the service did not have the required fax machine Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 17 Norton Avenue 17 Norton Avenue Burslem Stoke on Trent Staffordshire ST6 7ER     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 17 Norton Avenue 17 Norton Avenue Burslem Stoke on Trent Staffordshire ST6 7ER 01782819870 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Choices Housing Association Limited care home 6 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 6 Physical disability (PD) 6 Date of last inspection Brief description of the care home Norton Avenue is a purpose built, single storey home situated in its own grounds in Norton, a residential area of Stoke-on-Trent. It is one of a group of homes managed by the Choices Housing Association, which is a well-established provider of care for people 6 6 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home with learning disabilities in North Staffordshire. Norton Avenue is registered to provide care for six adults with a learning disability. It also has a variation to accommodate six persons with a physical disability.The home is conveniently situated to access local transport routes and a range of amenities. A disadvantage with its location is its position on a very steep road, as several of the people now require the use of a wheelchair to go out. The home has access to its own transport provided through the company. The current fees for the service is £221- 65 per week. The reader may wish to obtain up to date information for the fees from the service. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 star. This means that the people house the service experience good quality outcomes. This unannounced key inspection was carried out by one inspector between the hours of 08:00 and 15:30pm who used the National Minimum Standards for people under 65 years and outcomes for people who use the service as a basis for the inspection. Prior to the inspection we sent an Annual Quality Assurance Assessment (AQAA) for the manager to complete, this was returned to us prior to our visit and within the requested timescale. The document was comprehensive and provided us with information about the service. The completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are being met for people who use the service. It also gives us some Care Homes for Adults (18-65 years) Page 6 of 28 numerical information about the service. We were provided with documents on request, which included: staff training, menus, and care plans. We spent time with the people who use the service and observed the lunch and staff interaction with the people. We spent time, spoke and observed the people who were present at the service during the day. We had the opportunity to speak to staff not on duty who came to the service to support people in their life style What the care home does well: What has improved since the last inspection? What they could do better: During the inspection it was noted that the service did not have the required fax Care Homes for Adults (18-65 years) Page 8 of 28 machine If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to live at the service receive all the information they require and are assessed so that they can be assured the service can met their needs. Evidence: The AQAA we received prior to the inspection told us that the service had a clear Statement of Purpose the assessment of peoples needs were consistent with this document. Admissions were agreed following an assessment of individuals needs. The document contained the current fees covering a weekly placement. The Statement of Purpose and service users guide was made available to us. The document was simplistic, clear in its content and identified to the people the service they could expect. We received completed Have your say surveys from the people who use the service, each one confirmed that they had been asked if they wished to live at the home and each agreed they had enough information prior to moving in. One person confirmed that she had been asked to stay over night and for a weekend before making up her mind to live here. We were told by this person Its a good place to live I can do most things Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The service encourages contact with families and friends. Each of the people has an allocated key worker, one person confirmed to us who her key worker was. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their daily routines and social life style, and where able to do so in planning their care. Evidence: The AQAA we received prior to the inspection told us that each individual is assessed and his or her changing needs and personal goals were reflected in their person centered plan of care. Care plans were tailored to individuals and the support they may require to enable them to continue with their life style. Each person was consulted on their care plan and is encouraged to participate; this was evidenced from the pictorial review for one person. The care plans were detailed and tailored to the individuals skills, routines, risk assessments and issues such as what is important to them. A separate document is used to understand individuals peoples communication and body language demeanor to enable staff to support them. Each of the people have been assessed following the Mental Capacity Act guidelines, this was evidenced in the documents provided to us. We evidenced people making Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: choices throughout the day from what to have for lunch to go swimming or not. This option confirmed comments made by people in the completed Have your say surveys returned to us. Each person has an individual risk assessment, which highlights any changes to their routines. We were told by one person that she had a key worker and the name of the person. Comments on the day from people who use the service included: Its a nice home I like it here. Its like a family here. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported and are encouraged to experience a full lifestyle. Evidence: The AQAA we received prior to the inspection told us that the service enables people to live a life style of their choice. People participate in the weekly meetings and had good links with the community. This was evidenced during the inspection and from the records seen. People are encouraged to eat a healthy diet of their choice prepared from their contributions to the menus. Lunch on the day was a selection of food based on individuals choice. Individuals are encouraged to be part of the daily food preparation and baking cakes. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: No person at the service chooses to attend any of the local colleges and because of their ages do not attend a work placement. We observed the daily routine that was not disrupted by the inspection the people were relaxed and comfortable with all the staff and responded to their sensitive attention. During the year the records identified that people had taken holidays in various parts of the country with members of the staff to support them. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service meets the health and personal care needs of the people who use the service. Evidence: We were told in the AQAA received prior to the inspection that each person had a package of health care. Staff continuously monitors the needs of individuals, which details the manner in which they prefer their care and support to be delivered. Arrangements had been made to promote the comfort of individuals, with the provision of a pressure mattress, which had improved the interity of the persons skin. One person told me she was more independent with her new wheelchair,I am more comfortable and its better for me to get around. Each of the people was registered with a general practitioner who would visit if necessary. Peoples records for people who use the service identified that people using the service are given support from other professional agencies. Staff who administer medication were annually assessed for their competency by the registered care manager. There is a list of the signatures in the records of the people Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: who administer medication. Medication is stored in locked boxes within a locked kitchen cupboard. The people using the service are not prescribed controlled medication. Medication Administration records were seen and signed up to date. No person using the service was self medicating. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were supported to make complaints and are safeguarded by the services procedures. Evidence: The AQAA we received prior to the inspection told us that the service had a clear complaints process, which was formatted to suit the people and any other person and was seen to be displayed in the entrance. We spoke to staff who told us that they were aware from the training and induction the need to protect individuals. Any allegation of abuse would be reported with the knowledge that management would take action immediately. This confirmed the comments sent to us in the completed Have your say surveys. We saw the pictorial complaints procedure and were told that special arrangements were in place for one person. This included equipment purchased, enabling him to listen to a recording by the staff of the complaints procedure and the process he would need to report any concerns. We have not received any form of complaint against the service. No referrals had been made to the safeguarding team. The AQAA told us that the service had received no complaints. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design of the service enables people using the service to access all parts of the service and live in a well maintained environment. Evidence: The AQAA we received prior to the inspection told us that the service provides a safe, comfortable and homely environment. The service is located in a suburb of Norton, built to accommodate six adults. Bedrooms are individualised and personalised with possessions. We spoke to people and were told hey liked living here, I see my friends, Its my home and I go to my room if I want, I like my room its nice, Its good to live here, The staff are good and they help me. People who use the service are encouraged to assist the staff in simple housekeeping jobs as was observed during the visit with one person dusting, she told us that she did it daily. New carpets and curtains have been purchased to further enhance the environment. Within the lounge a new suite and flat screen television had been purchased. This room we were told is used in the evenings and for hand overs to protect the dignity of the people. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The AQAA told us that the company have a commitment to up-date the environment, plans include improved lighting in the entrance hall, more new furniture in peoples bedrooms. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and consistent staff support the people who use the service and keep them safe. Evidence: The AQAA we received prior to the inspection told us that the staff receive a full induction following their employment. The services recruitment was robust, and ensured that the right people were appointed to support the people. We evidenced from the staff files and confirmation by the staff on duty that they had checks prior to starting work. The service provides staff training to ensure that staff is adequately trained to enable them to support and carry out their duties. The completed Have your say surveys from the staff told us that they were in agreement that training provided was relevant to their role and it kept them up to date with new ways of working. With the exception of one person recently employed, each of the staff had National Vocational Qualification levels 2. The AQAA told us that the service has a good reputation for the retention of staff with one person leaving since the last inspection. We observed two staff files, they contained Criminal Records Bureau, and Protection of Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Vulnerable Adults checks, application form, training records and references. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are safeguarded by competent manangement systems which ensure peoples best interests are considered. Evidence: The AQAA we received prior to the inspection was returned within the requested timescale the document had been completed by the registered care manager. At the time of the inspection the service was being operated by the deputy care manager. The AQAA told us that the person was a Registered Mental Nurse and has completed the Registered Mangers Award, which was confirmed during the inspection. The acting manager has recently completed the training mentorship qualification. She continues to undertake training relevant to her post to enable her to run the service appropriately. Staff and people were observed to be relaxed with her style of management. people spoken to felt that they were supported and confirmed the Have your say I am proud to work at the home, The standard of care in all fields is excellent. The service had a quality assurance system in place to ensure the service operates Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: according to polices and procedures. Safe working practices were observed during the day. Records provided ensured the safety of the people in the event of a fire or other emergency. Equipment was serviced according to the requirements and the manufacturers recommendations. We saw minutes from the meetings with people who use the service, they were positive and covered various issues including food and holidays. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 The registered person shall provide for the purpose of managing the service appropriate facimile transmision equipment. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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