Care Home: Avon Park

What the care home does well The manager is good at assessing prospective residents needs prior to them moving in, so that the residents can be assured that their needs can be met. The manager works with a dedicated and stable staff team who get to know the individual residents well. The staff understand the residents needs and their preferences and they meet the residents expectations well. The residents really liked the staff and they said ` The staff treat us really well and they help us with everything we need`. All of the residents who returned a survey said that the staff meet their personal and health care needs. One visiting health professional said they would recommend this home as the staff were excellent at caring for the residents. The home is good at providing a range of activities that suit the residents. Although during this weekend inspection there were few activities people said that they did have plenty of ` things going on if they choose` The staff were seen going for a walk with a resident and the noticeboard advertised a range of activities. The residents said they liked the home cooked food. The residents views and wishes about their food are taken seriously and the menus change to reflect peoples preferences. The manager and the provider stated that their aim and their priority is to provide a comfortable home where they really care for the residents. The residents said that the manager and the owner were `wonderful` The provider was observed talking with the residents and cooking a lunch that the residents enjoyed. Two visitors said that the manager and the staff had cared for their relative really well. What has improved since the last inspection? The manager has now met all of the previous requirements including changing the care plans. These plans now include all the information that the staff need to guide them to meet all of the residents needs. The manager has ensured that the medication records are always completed for the safety of the residents. The manager has ensured that they obtain all of the information that is required when they recruit new staff for the protection of the residents. The staff have taken part in safeguarding training to protect the residents and this is now arranged on a regular basis so that all new staff can complete this course soon after they start work. The manager has made sure that they plan the staff training and that training is arranged more frequently. The manager has improved the system for staff supervision but this needs further improvements. Staff need to be supervised so that they are working to the managers expected standards for the benefit of the residents. What the care home could do better: No new requirements were made at this inspection. The manager is aware that they could further inprove the staff supervisions. Key inspection report Care homes for older people Name: Address: Avon Park 66 Southampton Road Park Gate Hampshire SO31 6AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kima Sutherland-Dee     Date: 0 6 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Avon Park 66 Southampton Road Park Gate Hampshire SO31 6AF 01489574616 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: alexandernethersole@btinternet.com Mr A Nethersole,Mrs Nethersole care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 30 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 ; Old age, not falling within any other category (OP) Physical disability (PD) Date of last inspection Brief description of the care home Avon Park is situated in a quiet residential area of Park Gate and is a short distance from the local shops and amenities. The home is set within its own grounds and has a large car parking area at the front of the home with attractive flower borders. Accommodation is arranged over 2 floors with stair lifts between floors. The rear garden is wheelchair accessible and has a walkway with grab rails for service users, the garden is well maintained and mainly laid to lawn with trees shrubs and flowers. The home is registered with the Commission for Social Care Inspection for a maximum Care Homes for Older People Page 4 of 24 Over 65 30 0 0 30 1 5 0 6 2 0 0 9 Brief description of the care home of 30 older people and older service users who have a physical disability. Fees range from £550 - £650 per week. Care Homes for Older People Page 5 of 24 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: We prepared for this inspection by reviewing the previous inspection report dated the 6th March 2009. We looked at the homes self assessment called the AQAA. The results of the residents and staff surveys are included in the report along with any relevant comments that the residents made. We visited the home on the 6th February when we talked to the manager and the provider Mr Nethersole as well as the residents and staff. During that visit we also spoke with a number of visitors and a health professional. We reviewed a sample of the documents including the care plans and the staff files, and we saw the home environment. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? The manager has now met all of the previous requirements including changing the care plans. These plans now include all the information that the staff need to guide them to meet all of the residents needs. The manager has ensured that the medication records are always completed for the safety of the residents. The manager has ensured that they obtain all of the information that is required when they recruit new staff for the protection of the residents. The staff have taken part in safeguarding training to protect the residents and this is now arranged on a regular basis so that all new staff can complete this course soon after they start work. The manager has made sure that they plan the staff training and that training is arranged more frequently. The manager has improved the system for staff supervision but this needs further improvements. Staff need to be supervised so that they are working to the managers expected standards for the benefit of the residents. Care Homes for Older People Page 7 of 24 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 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 Older People Page 8 of 24 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 9 of 24 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. Prospective residents have the information they need to make an informed decision about this home. Prospective residents can be assured that their needs are assessed prior to moving into the home. Evidence: The home had written information about the facilities and services and this was given to prospective residents and their relatives. Two service users said their relatives had been given this as well as a sample contract. In surveys received from those who live in the home all stated they were given enough information on the home before they moved in. Two people who were looking around the home were given a brochure. Prospective residents and their relatives are welcome and encouraged to look at the home before they make a decision. Two pre admission assessments demonstrated that the manager had assessed Care Homes for Older People Page 10 of 24 Evidence: residents needs to ensure those needs could be met at the home. The assessment included health and personal care needs as well as a persons likes and dislikes. This assessment is then used to develop a care plan when the resident moves into the home. Care Homes for Older People Page 11 of 24 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. The residents have their personal and health care needs met and they are treated with respect and dignity. Evidence: Three care plans showed that all of a residents needs are assessed and guidance is in place for staff to be able to meet those needs. The care plans included information about how the staff should support people with all areas of their daily lives including their personal hygiene, skin care, nutrition and medication. The plans also informed the staff about the residents recreational and spiritual needs. The staff knew each resident well and they were able to describe the care that people needed and how this should be done to meet the preferences of each resident. The residents views and wishes were recorded and the residents said that the staff were very good at helping them in a way they prefered. The care plans had been reviewed and changed regularly to reflect peoples changing needs. The staff knew when the residents needs had changed and this was communicated regularly each day. Eight out of the ten staff surveys received said that Care Homes for Older People Page 12 of 24 Evidence: they always had the information they needed about the needs of the residents and this was shared with the staff team. Two staff said this information was usually communicated to them. The residents health care needs were recorded and regularly reviewed. The residents said they could see a doctor of their choice whenever they needed to. A visiting health care professional said that the staff at this home work with us really well and they always followed any treatments. They also said The staff contact us as soon as a G.P is needed, I would recommend this home the care here is excellent. In surveys all the health professionals who responded felt the home always respected peoples privacy and dignity. Three residents said that the staff looked after them well. One person said We are spoilt here we only have to sneeze and the staff are there to make sure we are alright. Both the relatives surveys confirmed their relative always got the care and support expected. In surveys received from people living in the home, all confirmed they always received the care and support they needed. Half the staff surveys felt there were always enough staff to meet the individual needs of all people and the other half stated usually enough staff. The staff have been trained to safely help the residents with their medication. The medication was stored and recorded correctly. Each resident had been assessed to see whether they could manage their own medication or whether they needed staff help. This means that the home tries to support people to maintain their independence. The residents spoke about how much they can do for themselves and they said the staff were good at only offering help when it was needed. The residents said that the staff treated them with respect and they always maintained their privacy during personal care. Two visiting relatives said that the staff had been very kind and caring. They said This home is wonderful, the manager and the staff couldnt be better, they cared for our relative really well. The provider at the home is closely involved in the care and the residents said how much they liked them. The Provider was seen interacting with the residents and they clearly knew people very well, they were able to speak to people very respectfully but also with humour and in a relaxed manner. Care Homes for Older People Page 13 of 24 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 residents are able to choose their lifestyle at this home and there are activities that they can participate in. The residents benefit from a choice of homecooked food and from being able to influence and change the menu to suit their needs and preferences. Evidence: The residents said that they could choose how they spend their time and what time they get up and go to bed. They said The owner, the manager and the staff were perfect We are happy at this home The residents were happy with the activities that were available. They said they could choose whether to participate. A list of activities were advertised in the lounge and the staff maintained a list of who had taken part. One of the lounges countained a variety of equipement such as puzzles, games and books. This room is used for activities during the week. One resident said the home was quiet and they would like more going on but all the other residents said they were happy with the amount of activities. The residents have a meeting every three months and the minutes showed that the residents can give their opinions and these are taken seriously. The residents said Care Homes for Older People Page 14 of 24 Evidence: they enjoyed the craft sessions and the games. They added that they could go out into the garden if they choose to. One resident went for a short walk with a member of staff after lunch. The response to the residents surveys said that They are always trying to cater for our social needs. Two health professionals in surveys stated the home always responded to peoples diverse and individual needs, one stated usually. Both the relatives surveys felt the home always responded to the different needs of individual people. The residents said their visitors were always welcome. One person said they did not have visitors often but they were able to speak to them on the telephone. Visitors to the home said they were welcomed by the staff and offered tea or coffee. The residents said they liked the homecooked food and they could tell the staff if they wanted something different. Choices are offered but most people said they were not fussy and liked all the food. The manager and the provider were cooking during the weekend and they knew what food the residents liked. During the residents meeting in November people had commented that they would like a pie on Saturdays rather than another roast meal. The menu on the day of the inspection included a pie and vegtables. Other meal suggestions had been incorporated into the menus. The dining room was light and pleasently furnished and the residents said they liked socialising during meals but they could choose to eat in their rooms. Care Homes for Older People Page 15 of 24 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 residents are able to make a complaint and the home will follow the complaints procedure. The residents are protected from abuse through staff training and suitable procedures. Evidence: The staff give a copy of the complaints procedure to all new residents and their relatives. In the residents survey people said that there was always someone to talk to if they were not happy. They also responded that they knew how to make a formal complaint. Two health professionals surveys said that the home responded appropriately if there were any concerns. The residents said they were confident that the staff would listen to any concerns. The staff knew how they would respond to any complaints and they would always report these to senior staff or the manager. A copy of the safeguarding procedure is displayed in the hallway and this gives the residents and their relatives information about who they should contact. The home had a policy for any safeguarding concerns and the staff knew where this policy was kept. The staff have attended training to deal with any safeguarding concerns and they were able to describe what they would do if they had any concerns. This training is ongoing and available to staff every year so they can update their skills and knowledge. Care Homes for Older People Page 16 of 24 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 home is suitable for the current residents. Evidence: The home is suitable for the current residents. The residents said they liked their home and felt very comfortable. The residents can bring in their own items of furniture or personal belongings. Two residents said they had not chosen to do so but other people had brought things to the home. The residents said their rooms were well furnished and decorated. Four rooms were seen to be clean, comfortable and well decorated. The garden is fully accessible and well maintained. There are ramps,level areas and seating as well as a variety of plants and flowers. The home has a large lounge dining area and a seperate lounge which is used for activities. The home was clean and there were no unpleasant odours. In the residents survey the residents confirmed that the home was always clean and fresh. One relative commented that the home had spotless surroundings another commented that the cleanliness and outlook are very pleasant for everyone. Care Homes for Older People Page 17 of 24 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 residents benefit from a safely recruited, well trained staff team who work well together. Evidence: The residents said that there were enough staff and they did not have to wait long if they needed help. The staff survey said that half the staff thought there were enough staff to meet peoples needs. The rest of the staff thought there were usually enough staff. There were four staff on duty during this site visit as well as the manager and the provider who were cooking. The manager made sure that they changed uniform between cooking duties and caring. The residents said that the staff were wonderful and very kind. A member of staff said they liked their job and they had been at the home for a number of years. The staff training records demonstrated that staff were offered regular opportunities to attend a variety of training courses. These included infection control, food hygiene, medication, first aid and fire safety. The manager said that they had changed the way they organised training and they now made sure that courses were booked in regularly. The staff commented in the survey that they were given relevant training and kept up to date with new skills. The staff said thay had received a good induction training period when they started work so that they got to know their roles and responsibilities. The staff files were well organised and they contained all of the required information Care Homes for Older People Page 18 of 24 Evidence: for the safe recruitment of staff. This included criminal records bureau checks and two written references. The staff survey confirmed that the manager had carried out these checks before staff started to work at the home. In surveys received from staff members all confirmed their employer had carried out relevant checks on them before they started work in the home. In surveys received all staff stated they had received a good induction which had covered everything they needed when starting work. Staff reported in surveys they are given training which is relevant and kept up to date. One relative in a survey wrote, Nothing seems too much trouble for the staff and they do everything with a smile to brighten the day. Care Homes for Older People Page 19 of 24 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 residents best interests and they can contribute their views. Evidence: The home is managed by a registered manager who has been at the home for many years. They are qualified and they have updated their training. The manager is supported by the provider who lives on the site and is closely involved in the day to day work of caring for the residents. The staff and the residents praised the manager and said they were very supportive. One health professional in a survey stated. The manager is excellent and all staff are courteous and helpful. One relative wrote, the manager with all the staff are very informative, friendly and efficient. The residents can contribute their views in a number of ways including completing regular surveys and during residents meetings. The minutes of these meetings showed that changes had been made as a result of the residents comments. The manager has changed the way they plan and carry out staff supervisions and they Care Homes for Older People Page 20 of 24 Evidence: have plans to further improve this. The manager agreed that they needed to always record when the senior staff either instructed the junior staff, or when the carers had their work standards observed, as this is also a way of supervising the care staff. The staff all said that the manager was supportive and they said they had supervision often or sometimes. The home had all the required policies that relate to health and safety and these had been updated. The staff carry out regular fire checks and drills and these had been recorded. Care Homes for Older People Page 21 of 24 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 22 of 24 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 Older People Page 23 of 24 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!