Care Home: 3 Hainault Avenue

What the care home does well The home is nice and clean and has nice furniture. The home offers an excellent range of activities both indoors and out in the local community. The support plan is written around what the person living in the home wants. Staff are well trained. What has improved since the last inspection? The home now makes sure that the person living there knows about any extra payments that they have to make. The support plan includes all aspects of health and well-being and is regularly reviewed. The home makes sure that checks are made on all of it`s staff. The home gives staff more training. The home has regular visits from other managers to check that it is doing things right. There are now instructions to staff on when, why and how as and when prescribed medications are to be given. What the care home could do better: The home`s information paperwork should be looked at regularly to make sure it is up to date. The staff should have supervision at least six times each year. The manager should have regular supervision. The manager should have more time to do management jobs. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Hainault Avenue 3 Hainault Avenue Rochford Essex SS4 1UH     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: Pauline Marshall     Date: 0 5 0 6 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 26 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 26 Information about the care home Name of care home: Address: 3 Hainault Avenue 3 Hainault Avenue Rochford Essex SS4 1UH 01702545753 F/P01702545753 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Estuary Housing Association Ltd care home 1 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 1 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 1 to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability Code LD Date of last inspection Brief description of the care home 3 Hainault Avenue is a bungalow that is a home for one person who has a learning disability. It has one bedroom, a lounge and dining area, a conservatory, a kitchen, a bathroom and an office that staff also sleep in each night. There is a garden at the back of the bungalow and grassed area to the front. You can get out into the garden through the conservatory doors. The home has its own car and there is parking at the front of the bungalow. Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home The home will give people interested in using the service a copy of its information paperwork and it costs £2999.72 per week and people will have to pay a contribution towards this. People will also have to pay for hairdressing, papers and magazines and spending money. Care Homes for Adults (18-65 years) Page 5 of 26 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: We visited the home and looked at the files belonging to the person living in the home and the homes staff. We also looked at the policies that explain how the home does things. We looked around the home and spoke to the staff and the manager. We read the information (AQAA) sent to us by the manager. The AQAA is a form required by law for the manager or provider to carry out a self-assessment of how well the outcomes of people using their services are being met. We sent surveys to the person living at 3 Hainault Avenue and to some professional people that visit the home and to some of the staff to see what they think about it. We Care Homes for Adults (18-65 years) Page 6 of 26 have added any comments that we got from these 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.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 8 of 26 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 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot be sure that the information provided by the service is up to date. Evidence: The homes Statement of Purpose and Service User Guide did not show the date that the documents were last reviewed and some of the information contained within them was out of date. Both documents should be regularly reviewed to ensure that they provide up to date information on the service the home provides. There was no pre-admission assessment documentation for the person using the service; the registered manager said that the person had lived in the home since 1998. There was evidence that regular reviews and assessments had taken place since then. 3 Hainault Avenue provides a home for one individual only, therefore, no new admissions to the home are expected, however the provider has policies, procedures and pre-admission documentation to show that the pre-admission assessment process Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: is thorough. The person living in the home showed us a written statement of their terms and conditions with the home and confirmed that these were regularly amended to show any changes. Care Homes for Adults (18-65 years) Page 11 of 26 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. People receive appropriate individualised care based on their identified needs. Evidence: We looked at the care file belonging to the person using the service and found that there was support plans for all areas of care that included bathing, hair care, grooming, getting up/going to bed, understanding, expression, family, food likes and dislikes, excercise, traveling and hobbies and interests. When spoken with the person living in the home said they were more than happy with their support plan and confirmed that they had been involved with its creation and that it was reviewed regularly. There was evidence on each of the support plans that they had been reviewed on a regular basis. There was risk assessments and management plans showing how the risk is managed in areas such as, use of the kitchen, going out into the community, horse riding and for using equipment such as the lawn mower. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: We asked the person living in the home about meetings and they confirmed that regular talks with staff take place and that they were very much involved in what happens in the home and were able to choose what they wanted to do and eat; daily notes and notes of meetings confirmed this. Care Homes for Adults (18-65 years) Page 13 of 26 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 well supported to live a lifestyle that meets their identified needs and preferences. Evidence: We looked at the daily planned activity sheets and discussed them with the person living in the home and they confirmed that they are supported to attend a range of activities including, voluntary work at Southend Stadium, work at a local farm, horse riding and trips out. The person living in the home writes their own daily notes in their report book and entries in this book confirmed that the above activities take place regularly. There was evidence that the person living in the home maintained family relationships and when spoken with the person said staff takes me home every month to see my Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: family. The person living in the home said that they were happy with this arrangement and that if they wanted to go home more often they could. We looked at the records of the food served at 3 Hainault Avenue and they showed that a wide variety of healthy foods was supplied. The person living in the home said that they liked take-away meals, and the records showed that these were provided occasionally. The person living in the home is supported to cook their own lunch and snacks wherever possible and it was clear from discussions with them that they enjoyed doing so. Care Homes for Adults (18-65 years) Page 15 of 26 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. People will receive good personal and health care in a way that meets their individual needs. Evidence: We looked at the support plan and it showed that personal care is provided by way of prompting and supervision; the person using the service said when spoken with staff reminds me to do things that I sometimes forget to do and staff spoken with confirmed that the person required verbal prompts and guidance to maintain their personal hygiene and to dress appropriately. There was records to confirm that the person using the service had regular health care checks that included dental checks, GP and practice nurse visits and routine checks with their consultant psychologist. We received a completed survey from a health and social care professional who said they look after the client, staff are able to work together with us to provide a good service and the client appears happy and well. The support plan showed that the person using the service is not able to administer Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: their own medication and there was a risk assessment in place that showed how medication was to be managed. The medication administration sheet (MARS) was checked together with the medication and we found it all to be accurate; there was a protocol in place for the use of as and when prescribed (PRN) medication. The medication was stored in a locked cabinet in the office and the training records showed that staff administering medication have had medication training. Care Homes for Adults (18-65 years) Page 17 of 26 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 know that their concerns will be dealt with and that they will be protected from harm and abuse. Evidence: We have not received any complaints about 3 Hainault Avenue and the registered manager confirmed that no complaints had been received by the home since the last inspection. The homes complaints procedure was displayed in a pictorial format on the notice board and the person using the service said when spoken with I would tell the manager or the staff if I was not happy and they would do something about it. The homes safeguarding policy was dated January 2006 and in December 2008 an update was added to include the Mental Capacity Act. Staff spoken with were aware of the procedures for safeguarding people using the service, and there was evidence on the staff files examined that all staff had been trained including the agency staff that are currently used by the home. Care Homes for Adults (18-65 years) Page 18 of 26 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 safe environment. Evidence: We looked around the home and we found that it was comfortably furnished and fairly well decorated, however staff said that the bungalow was due to be redecorated and that colours had been chosen and soft furnishings purchased and stored in the garage. The one bedroom has an en-suite toilet and wash basin and the person living in the home is able to lock the room if they wish to do so. The bedroom had many personal items such as a large cardboard cutout of Elvis Presley and lots of trophies that the person using the service said belonged to them. The home was clean and hygienic and the maintenance records showed that any repairs are carried out in a timely manner. Care Homes for Adults (18-65 years) Page 19 of 26 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 will be supported by competent well-trained staff that are safely recruited. Evidence: The home employs two people, the registered manager and one other member of staff and two regular agency staff are used to support them. The rotas showed that staff works around the activities of the person using the service and that when they are out of the building there are no staff on duty. The registered manager said that he works alone on shifts and has been allocated two hours a week to carry out management tasks that includes the supervision of staff, preparation of rosters, reviewing of care plans and updating policies and procedures as well as keeping up to date with legislation. It was clear from the support plans, the daily notes and our observations that the person using the service requires a high level of supervision and input from the staff. There was minimal time allocated on the rota for management duties and it showed that a handover between the registered manager and the staff member took place once a week only. There should be time built into the shift pattern to allow a crossover between the staff and registered manager to ensure that relevant issues are discussed. We looked at the two permanent members of staffs files, and the records kept for the Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: agency workers that regularly work in the home and we found that they contained all of the relevant documents, which included evidence of criminal records bureau checks (CRB), written references, and training certificates. The member of staff has achieved an NVQ level 3 qualification and has recently had training in medication, moving and handling, health and safety, safeguarding, team building, managing conflict, first aid, the mental capacity act and deprivation of liberties. There was an agency profile for each of the agency workers that currently work in the home and for several others that have worked over recent weeks. The profiles confirmed that the agency worker had a satisfactory criminal records bureau check (CRB), 2 written references and gave details of the agency workers training including the date when updates were due. Staff supervision does take place but the evidence showed that it was not as often as required in the National Minimum Standards; the registered manager confirmed this. Care Homes for Adults (18-65 years) Page 21 of 26 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. People will live in a well run home that is run in their best interests. Evidence: The registered manager has many years experience, and has an NVQ4 care qualification and is nearing completion of his registered managers award. Since the last inspection the registered manager has regularly updated his practice and had training in food hygiene, understanding valuing people, safeguarding, budgeting, epilepsy, autistic spectrum, mental health, the mental capacity act and deprivation of liberties and aspects of ageing. There were no records to show that the registered manager had received supervision himself and he confirmed that none had taken place. The organisation should ensure that the registered manager is fully supported to carry out his role and provide him with regular supervision. As stated in the last section of this report the registered manager is allocated two hours each week for all of his management tasks; this should be reviewed by the organisation to ensure that all staff are fully supported in their work. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: There was no evidence to show that the home carries out regular quality monitoring of the service it provides, however, it was clear from discussions with the person using the service that their views are regularly sought. There was evidence that regular visits from the representative of the organisation take place and the registered manager returned his annual quality assurance assessment (AQAA) by the required date and it provided us with the information that we had asked for. We checked the fire records, electrical safety certificate, portable appliance testing (PAT) records, gas soundness certificate, employers liability certificate and the homes records of water temperatures and found them all to be in place and up to date. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 1 It is recommended that the Statement of Purpose and Service User Guide is reviewed regularly and updated so that it includes current information. It is recommended that the registered manager provides all staff working in the home with supervision at least six times each year to ensure that staff are fully supported in their work. It is recommended that the organization provides the registered manager with regular support and supervision to ensure that he is fully supported to manage the home. It is recommended that the organisation provides the registered manager with sufficient time to carry out his management tasks including the supervision of staff to ensure that staff are appropriately supported in their work. 2 36 3 37 4 37 Care Homes for Adults (18-65 years) Page 25 of 26 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. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!