Care Home: 2 The Avenue

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What the care home does well All the comments received from the people living in the home were very positive. Some of these include `carers are excellent` and `I love it here`. `Its clean and comfortable`. The `soups are very good` `food is very good and we have choices`. I `have nothing to complain about`. The staff `calls the doctor when you need them`. `I could not fault the place`. The families spoken to at the inspection said that `this is a lovely home` and `very clean`. `Communication with staff is great` and they are always `smiling`. The `new owner`s are approachable and nice`. `Home has lots of entertainment and activities`. The `atmosphere is homely and no smell`. `The acting manager is nice and I am glad she is back`. The staff say the `people get looked after well and they enjoy working at the home. We were also told that the `induction and training in the home is very good. What has improved since the last inspection? The last requirement was met and the outside of the home was painted. What the care home could do better: Ensure that the relevant information is obtained when staff start work at the home. The staff file`s need to be better organised. Inspecting for better lives Key inspection report Care homes for older people Name: Address: 2 The Avenue 2 The Avenue Spinney Hill Northampton Northants NN3 6BA     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: Ansuya Chudasama     Date: 0 1 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 Older People 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 Older People Page 2 of 23 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: 2 The Avenue 2 The Avenue Spinney Hill Northampton Northants NN3 6BA 01604644455 01604644455 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Matthews Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 28 The registered person may provide the following categories 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: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Care Homes for Older People Page 4 of 23 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This home has 2 star rating and this means that the people using the service receive a good service. We visited the home unannounced on the 1st of February 2009. We spoke to the Acting manager and staff, and some of the people who live in the home. We looked at information about policies and procedures, which tells the staff how to do things in the home. We looked at the training that they do to look after the people living in the home. We looked at information about some of the people who live in the home to find out how their needs are being met by the staff. This is called case tracking. We watched Care Homes for Older People Page 5 of 23 how the people living in the home and staff got a long together. The home had sent us their annual quality assurance assessment (AQAA) when we asked for this information. The information from this document has been used in this report. What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The people and their representatives are provided with information and encouraged to visit the home prior to making a decision to stay Evidence: The home has a Statement of Purpose and a Service User Guide and a copy is given to the people and their families. This is so that they are aware of the services being offered and know that their needs can be met by the home. The people spoken to said that their families had visited the home and liked it very much. One family said that they knew that this was the home for their family member as soon as they felt the atmosphere. The people in the home said that they like living at the home. The manager said that they carry out assessments before a person is admitted to the home. The revised assessment form seen was good and had all the information needed to look after the person at the home. The information could be expanded Care Homes for Older People Page 9 of 23 Evidence: further as discussed at the inspection. The people told us that they had a contract with the home and this was signed by them or by their family member. Care Homes for Older People Page 10 of 23 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Care plans are individualised to each person so there fore the staff know how to meet their assessed needs. Evidence: Evidence showed that all the people had care planning documents, and risk assessments. Information read in the care plans showed that the peoples personal, and health care needs were recorded in detail. Families spoken to and the people said that they were informed of their care plans. The plans were being reviewed on a monthly basis and yearly reviews were being carried out with the funding authority. One person spoken to said that the staff help me all the time and they are ever so good. Another person said I use the buzzer and they are there to help me. We were told by another person that they staff help me get on and off the toilet and they are very good at doing this. All the people said that the staff always knock on their door before they come in their room. Care Homes for Older People Page 11 of 23 Evidence: The care records seen showed that the relevant health professionals were being called out when needed. The people spoken to said that the staff call the doctor when you are not feeling well and they look after you well. Families spoken to also confirmed that the staff kept them informed of their relatives progress and when they were ill. The staff watched videos on how to deal with people who are very ill and we were told that the staff had a session with the funeral directors to learn about how to manage people who have passed away. The home had policies and procedures on medication, and the medication records and medication cupboard inspected showed that this was good. The senior staff on duty gave out medication. The manager also monitored staff when giving out medication. We were told that more staff are going on medication training. Care Homes for Older People Page 12 of 23 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. The people in the home enjoy good healthy food to ensure their needs are met Evidence: The inspector sat with the people and had lunch with them in one of the two dining rooms. The food sampled was very good. This was confirmed by talking to people on the table. One person said we have a lovely lunch and they give you lots to eat. Other people said that you get lots of choices. One person said that the cook was very good The staff were observed being very supportive and talking to the people in a pleasant manner. It was also good to hear both staff and the people having banter with each other. We were told that the home has regular feedback on menus to get a clear picture of what the people like to eat. We were told that one day the people had fish and chips bought in from the out side and every one enjoyed this. The dining room the inspector sat in needed to be brighter when people are having their meal. This was discussed with the manager who stated that brighter bulbs would be put in the room. The door of the lounge door was kept open by a stopper. This was a fire door. We were told that the home had asked the Fire Officer if they could leave the door open at mealtime until the fireguard was fixed to the door. The Fire Officer Care Homes for Older People Page 13 of 23 Evidence: agreed this. The people told us that after lunch they go to the lounge and have tea and biscuits. The people informed us that there is always something going on during the week time. The activity organiser visited five days a week and provides a range of activities including making cards, reflexology, gardening, cooking, going out and hand massage. Other entertainment is also brought to the house and a gentleman comes twice a month and undertakes armchair exercises with the people. The relatives spoken to stated that lots of different activities were taking place in the home. The people informed us that their family visit them at the home and they also go out with them. We were told that they can visit any time and it was not like a hospital. The staff supported them with this. The home encourages families to get involved with meeting the care needs of the people and with any social activities that are happening in the home. The staff told us that the home has meetings once a month with the people and their families are invited. The minutes of the meeting read showed that activities and menus are discussed. The staff support the people to make their bedrooms individualised to meet their needs and people are able to bring in personal items from their home. Care Homes for Older People Page 14 of 23 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 home has a clear complaints procedure and the people know who to speak to if they are not happy Evidence: The home has a complaints procedure and the people are informed about this. The complaints book inspected showed that complaints were being dealt with in a satisfactory manner. The people spoken to said that they would tell the staff, the manager or their family if they were not happy. We were also told that there is a complaints book in the front of the home for people to write any concerns they have if they were not happy. Families spoken to also stated that they knew how to make a complaint and it was stated that they would speak to the staff if they were not happy about any thing. The staff spoken to stated that they had done training on safeguarding of vulnerable adults procedures. They gave examples of how they would be able to tell if a person in the home was unhappy. It was said that this was by understanding the behaviours and the body language displayed by the people. Care Homes for Older People Page 15 of 23 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, 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. 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 homes premises were clean and homely to meet the peoples needs. Evidence: The tour of the home showed that the home was clean and tidy and had a homely atmosphere. The people and families spoken to say that they choose the home because it had a nice homely feel to it and it was very clean. The home had a maintenance book and we were told that the environment outside had been painted. The peoples bedrooms were individualised to meet their needs. Care Homes for Older People Page 16 of 23 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The staff are enthusiastic and therefore work positively with the people to improve their whole quality of life. Evidence: The staff recruitment files inspected showed that all the files looked at had the information needed as stated in the standard. But one file looked at showed that the person was employed by accepting their previous Criminal Records Bureau (CRB) check document, which was undertaken on the 7/10/08 when they worked for an agency. The staff on duty was given advice by the proprietor that it was acceptable to start a member of staff on a previous CRB check. The Staff started work on the 11/11/08 and their POVA first check came on the 24/11/08 and their CRB check arrived on the 29/11/08. We were told that the staff member did not work on their own until they received their CRB check. The acting manager was on leave when this happened but they understood that every time a new member of staff started work at the home, they had to have a new POVA and CRB check. The staff files also needed to be better organised. The staff told us that they have monthly staff meetings and they get on well together as a team. They also enjoyed working at the home and told us that the people in the home get good care and have a good social life. The people in the home said that the staff were excellent Care Homes for Older People Page 17 of 23 Evidence: and they helped them to do things. We observed staff working well with the people in the home. The home has also maintained good staff retention to provide continuity of work and support to the people. We were told when the home is short staffed; they get bank staff from the organisation. They also try and keep to the same staff each time. Staff spoken to confirm that they received good induction training linked to skills for care, when they start work at the home. It was also said that they get lots of very good training from the new proprietor and they receive supervision. The manager had started doing a training matrix for all staff. The home has more than 50 of the staff with NVQ level 2 or 3 training in care. Some of the staff were doing this training. We were told that the Local Authority also provided good training. Care Homes for Older People Page 18 of 23 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 home is run in the best interest of the people living in the home. Evidence: In July 2008 the home was registered under new ownership of St Mathews LTD. The manager of the home left and the deputy manager who had been at the home since July 2007 is now the acting manager of the home. She has 12 years experience of working with older people and 5 years experience in management. She has undertaken the Registered Managers Award and is going to undertake her NVQ level 4 in care. The acting manager has put in an application to become the registered manager of the home. The staff and the people and their families say that the acting manager is very good and supportive and approachable. The home had carried out a survey questionnaire for families to complete in August 2008 and one was done for people living in the home and for stakeholders involved in the home. All the information received was very positive. The analysis from the Care Homes for Older People Page 19 of 23 Evidence: feedback is sent to the peoples relatives and given to the people Weekly fire drills were being undertaken and monthly emergency lighting was carried out. A fire risk assessment was also carried out for the home. The staff confirmed that they had fire drills and they also had training on health and safety and safe working practices. The people or their families managed their finances and the home did not get involved with the peoples money. The accidents and incidents that occurred at the home were being reported to the CSCI under regulation 37 of the Care Standards Act. Care Homes for Older People Page 20 of 23 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 Older People Page 21 of 23 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 1 29 9 New staff must not start work until all the relevant information is obtained This is to ensure that the people are protected from any harm 19/02/2009 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 Care Homes for Older People Page 22 of 23 Helpline: 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 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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