Care Home: 22 Prices Avenue

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What the care home does well The registered manager and staff have provided good person centred plans in ways that meets the communication needs of people who live in the home. The home is active in making sure people living there know how to make a complaint and how to let people know if they are unhappy about anything. People told the expert by experience that they are aware of the complaints policy and one said if he was not happy he would tell the staff or the manager. All people have a folder called `My medication` that is written in a person centred manner and indicates any particular needs they may have regarding their individual medication. Individual activities are encouraged in house and in the community. What has improved since the last inspection? The recommendations made at the previous inspection have been met. Environmental improvements are being planned and is either in the process of being undertaken or are planned for the very near future. What the care home could do better: The company could improve the registered managers role by providing a computer system for the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 22 Prices Avenue 22 Prices Avenue Cliftonville Margate Kent CT9 2NT     The quality rating for this care home is:   three star excellent 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 Gabriel     Date: 0 4 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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.csci.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: 22 Prices Avenue 22 Prices Avenue Cliftonville Margate Kent CT9 2NT 01843293927 F/P01843293927 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Wolstenhulme Type of registration: Number of places registered: CareTech Community Services (No.2) Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning 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 - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home 22 Prices Avenue is a semi detached house with six single bedrooms, the bedrooms are situated on the first and second floor of the property. There is no lift facility within the home. The home is registered for six adults with learning disabilities aged between 1865 years. The home promotes person centred living. Service users are actively encouraged to maintain and develop personal independence and choice. The home is located in the residential area of Cliftonville, within short walking distance of local shops and amenities. Fees range from £830-£1,702.31 Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 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: three star excellent 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 service received 24 hours notice before this Key Inspection. This was to make sure that people would be available to speak to an Expert by Experience. An expert by experience is a person who, because of their shared experience of using services, visits a home with an inspector to help them get a picture of what it is like to live in or use the service. Staff were very pleased to welcome the expert by experience into the home and commented on what a good idea it was. The home was fully staffed plus the registered manager. One person was in hospital at Care Homes for Adults (18-65 years) Page 6 of 28 the time. Other people were enjoying different activities supported by staff. Activities and learning opportunities are varied and encouraged. Staff are actively seeking work placements for some people who have requested this. The home has met the recommendations made at the previous inspection. The registered manager and staff have been very pro-active in providing person centred plans to meet different communication needs. The registered manager and staff have a development plan for the coming year, to make indoor and outdoor environmental improvements and to create a sensory garden. 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 Adults (18-65 years) Page 8 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 9 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. Prospective service users know that the home takes care to ensure their needs are met and that they have suitable information to make an informed choice before moving into the home. Evidence: The registered manager said that the home uses the assessment of the placing authority as well as the homes own assessment format for a prospective service user. Information is also sought from health care professionals. When a new person comes to live in the home they will be monitored for a period of time when they first move in. The registered manager has recently reviewed the statement of purpose and there is a clearly written and illustrated service user guide for new service users and their relatives to help them make an informed choice about moving into the home. The registered manager said that the company enabled her and the staff to make unhurried decisions about whether the home can meet the needs of a prospective Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: service user and to assess whether that person would feel comfortable with the other people who live in the home. The expert by experience said that he was welcomed when he came into the home. Part of a letter seen from a health care professional, states that a service user has made good progress due to the hard work the team has dedicated to that person. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their changing needs are reviewed and supported and that risks are assessed and abilities promoted. People know that they are consulted about aspects of life in the home and that they are supported to live an independant lifestyle as able. Evidence: Two service users care plans and person centred plans were viewed and crossreferenced with individual health action plans. These are of good quality and contain plans for staff to support assessed needs and personal goals. One person said he could choose his favourite meals. Other general conversation and observation with people living in the home indicated that staff not only enable choice but actively encourage people to make choices. Guidelines seen in the plans reference this. The staff has given a lot of consideration to providing a person centred plan that is Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: readily understood by people who may not make use of the written format. One person spoke about the picture on his bedroom wall that staff had created as his plan and that he understood and enjoyed. A different style format was used for another person. This is excellent practice. Person centred plans and risk assessments are regularly reviewed. Plans include communication guidelines. Communication was observed to be suitable for different needs and preferences. Regular reviews are undertaken and a written comment by a social worker stated that reviews are attended by knowledgeable and enthusiastic staff. The company is in the process of arranging for people who live in the home to review the contents of their own care plans and redesign the format. Individuals, with their support worker, will attend meetings with other people from co-owned homes and discuss, review and make changes that they feel is better practice. This is excellent person centred practice. The expert by experience told us he had seen the very good interaction between a member of staff and a person with impaired vision. The expert by experience report noted that : - One service user said he is currently going to special meetings where he is reviewing his person centred plan and is very happy about this and looking forward to the party at the end of the review process. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are enabled to take opportunities for personal development. People are encouraged to take part in wide range of appropriate activities both in-house and in the community. Relationships with family and friends are supported. Rights and responsibilities are respected by staff. People are offered a balanced diet. Evidence: People have a wide range of leisure activities and learning opportunities. This is all recorded. Staff are helping two people to find work and one person works as a volunteer in a local newsagents. The rapport between staff and people living in the home was very good and seen to be supportive. The banter was lively, friendly and appropriate and there was a lot of happy chatter especially at mid-day when people were preparing for lunch. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Some people take responsibility for household tasks. One person assists with the weekly checks on the homes vehicle. Some people have attended fire training and have certificates to show they understand the importance of fire safety. One person answered the front door and made sure the inspector showed her identification card before inviting her into the house and then made sure the visitors book was signed. One person talked about the outings and holidays he and other people went on and the registered manager said that they did not all go away together but as and when people chose a place to visit. Going to the theatre is popular, both locally and in London. One person had tickets to see a pop concert in London. Pathways, Gateway and a day centre are attended and some people go to the adult education centre for a variety of subjects. Families are welcomed and some home visits take place. The kitchen is due to be completely renewed to accomodate an ergonomically sound working environment. People returned from shopping with food for the house and this included fresh meat and fruit and vegetables. Menus are varied and weekly meetings let people make choices. One person said he liked his dinner and that he could look at pictures to help him choose. The expert by experience report noted that : - A staff member said that there are many leisure places to go to around Margate and the service users enjoy going out in the homes car to the pubs and clubs. That one service user said he had been living in the home for some years and would not like to change anything in the home. He said he came to the home (when no longer able to be supported) and he loves being in the home. There is a menu which is in picture form. Services users who have no verbal communication can point to choose what they would like on the menu. Meetings are held regularly. Service users can say what activities they would like to have. Service users have choices of what to do in the day. One said he goes for walks or on the bus by himself and needs only tell staff where he is going. Friends and family are free to visit the service users at home. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal support and care needs are met. Medication practices are safe and encourage individuals participation. Evidence: Personal care plans are recorded in individual plans and include information about preferred ways of receiving support. These are regularly reviewed. The medication procedure is robust and staff receive training and six monthly in-house checks on their competency and confidence. People have their medication administered to them in a way that suits their particular needs. The registered manager said she is trying to obtain individual storage facilities for each person in their own rooms. Medication to be taken when required is reviewed six monthly. Health action plans contain detailed recording of all health care appointments and outcomes. Each person has a workbook called my medicine where they write down, with support from their key worker, what their medication is and how and why it is taken. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The expert by experience noted that : - The stairs to the bedrooms have rails fitted. This was done to make movement upstairs easier for one service user with (particular health needs). He also goes to the gym to (support his health needs). Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have their views listened to and acted on. People are protected from abuse. Evidence: Staff receive adult protection training and a new member of staff was clearly able to understand the importance of reporting any suspicion of abuse. All staff except for the new member of staff had undertaken adult protection training and two were due for refresher training. Training is also given on safeguarding adults. The home has a complaints procedure and policies. Each person living in the home has a folder in his room with photographs and pictures explaining the complaints procedure and how they can tell someone if they have any worries or concerns. This is written in a clear and simple manner. The home has also made videos as a different form of communication to make sure all of the people living there understand how to let people know if they are not happy. The home has an adult protection policy. There has been no adult protection issues raised since the last inspection. Peoples individual finances that are looked after by the home were seen to be recorded Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: and receipts and cash held corresponded with the sample viewed. The expert by experience noted that:- Service users are aware of the complaint policy. One service user said if he was not happy he would tell the staff or the manager. 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. People live in a homely, comfortable and safe environment. Bedrooms meet peoples needs and lifestyles and promote independance. Specialist equipment promotes independance. The home is clean and hygienic. Evidence: The home was clean and hygienic. The lounge is to have all new furniture, new carpets and curtains. People have already chosen their furniture and colours for the room and items have been ordered. A bathroom was in the process of having new tiling and shower screen. The laundry has a new washing machine. Plans for the coming year includes new flooring and chairs to the dining room, some new bedroom furniture, new boiler and repair and new tiling to the front entrance area. Two years ago the home was completely rewired and maintenance certificates indicated that the electrical testing was up to date. There is an action plan to redesign the garden next year to include herbs, vegetable and sensory areas. The garden is attractive, tidy and accessible. Bedrooms are individual and there are adequate bathrooms for the people living in the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: home. One person has particular mobility needs and to enable his independance, the home has installed hand rails to the stairs. The expert by experience noted that :- The home was undergoing refurbishment during our visit. The lounge is of good size. The kitchen/dining room are large and have a large dining table to accommodate both staff and service users. There is a nice accessible garden where service users have barbecues in the summer. 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. People are supported by an effective staff team who are competent and qualified. People are protected by the homes recruitment policy. People benefit from appropriately supervised and supported staff. Evidence: A recommendation made at the last inspection for staff to receive service specific training has been met and is on-going. There was evidence on a training matrix that indicates the training obtained and arranged. NVQ training is ongoing and at least half the staff has obtained or are undertaking NVQ level 3. The newer member of staff confirmed forthcoming training and that he had undertaken induction training when first starting employment with the home. A staff file seen had evidence of regular supervision. The company has a personnel department that supports recruitment in the home. There are currently two wake night vacancies and interviews have been arranged for Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: these posts. Recruitment checks are robust including CRB checks and references. About a year ago, the staff won the top team award presented by the company and a presentation was made to the home. The expert by experience noted that: - There were four members of staff on duty on the day and all seemed to interact well with the service users. Staff are very supportive and helpful. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home and they benefit from the ethos, leadership and management approach of the home. People can be confident that their views are listened to and that these underpin self monitoring and development by the home. Policies and procedures protect peoples health, safety and welfare. Evidence: The registered manager has many years experience of working with people with a learning difficulty and has the required qualifications for the national Minimum Standards. The registered manager said there is a good line management system for the company and that all are very supportive and available. Managers in the company have monthly meetings and the company offers a range of monthly training for all managers. The home does not have a company computer system. This is a pity as it would give the registered manager and staff the opportunity to access the CSCI website and other Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: varied and pertinent information for the home. The registered manager and the district manager who spoke briefly on the telephone, said that this would be valuable but that the company had not yet considered supplying the homes. Staff said that the registered manager is open and approachable. People living in the home and staff have their own monthly meetings. The company has a dedicated maintenance team. Up to date maintenance certificates were seen for electricity, and gas provision. The fire records book was up to date. The home uses feedback sheets as quality assurance. Some of these viewed indicated a good level of satisfaction from families and health care professionals and others. One family member wrote that their relative is now enjoying life much more. Another family wrote that they thank their lucky stars for the way the home looks after their relative. Another said that the atmosphere was happy and relaxed. A representative of the maintenance team said that the staff had been helpful and cooperative. A social worker wrote that the staff who attend reviews were knowledgeable and enthusiastic. The expert by experience noted that : - I did not find anything negative about the home. 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 Care Homes for Adults (18-65 years) Page 27 of 28 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!