Care Home: Avondale

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What the care home does well People said that they "like living here". They feel that they get good support to lead their own lifestyle. Care records are person-centred and very clear, so staff know how each person wants to be supported. Staff understand peoples` rights to make their own decisions, and they encourage people to do this. People living here choose their own weekly menus. Medication is now managed in a better way. The home achieved the highest award (5 stars) for its excellent food safety. All the bedrooms have a private en-suite shower and toilet. Staff feel that they are very well trained so they know how to support people in the right way. The manager and staff try to run the home in the best interest of the people who live here What the care home could do better: The provider must replace the unfitted bathroom flooring with suitable, fitted, non-slip flooring. This is to prevent residents and staff from tripping. The provider must ensure that lighting in all areas of the home is sufficiently bright for residents` safety. The premises shortfalls from this inspection must be addressed, for example rusting shower chairs, cracked walls, peeling paint to laundry ceiling, and chipped paintwork. This is to make sure that people live in accommodation that is in a good state of decoration. Random inspection report Care homes for adults (18-65 years) Name: Address: Avondale 6 - 7 Nelson Terrace Redcar TS10 1RX one star adequate service 26/05/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Andrea Goodall Date: 2 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Avondale 6 - 7 Nelson Terrace Redcar TS10 1RX 01642494509 F/P01642494509 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Karen Birchall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Potential Limited care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning Disability Code LD. Date of last inspection Brief description of the care home Avondale is registered as a care home for up to twelve people with a learning disability. The Victorian building is two houses which are linked and they are as one home. All bedrooms are for single occupancy and have en-suite shower and toilet facilities. The home has large communal rooms and there are: a dining room, three lounges, a kitchen, bathing facilities and four bedrooms on the ground floor and eight bedrooms on the first floor. There are small gardens to the front of the house that Care Homes for Adults (18-65 years) Page 2 of 10 2 6 0 5 2 0 0 9 Brief description of the care home overlook Redcar cricket field. The home is close to the sea front and the main shopping area. The fees charged to people who use the service range from £635 to £2000 per week, but the actual amount payable depends on peoples individual circumstances Care Homes for Adults (18-65 years) Page 3 of 10 What we found: Before the visit we looked at information we have received since the last key inspection visit on 26th May 2009. At the last inspection there were many requirements relating to the premises. Following the inspection an action plan was received from the provider showing the programme of works to address those shortfalls. During the visit we looked at most areas of the premises to check that previous requirements had been met. We also looked at any changes to how the home is run. We asked the Provider for their view of how well they care for people in their AQAA (an annual quality assurance assessment). The AQAA was very detailed and showed a number of improvements to the service. We received surveys from seven residents and nine staff. The comments from residents were very positive. For example a resident said, I like the staff, they help me do different things. I like living here. Surveys from staff were also positive, especially about training opportunities and the improved management of the service over the past year. For example, a staff said, The home cares very well for the residents. All staff are trained in the correct way, and the home is run in a very professional manner. We made an unannounced visit to the home on 26th May 2010. During the visit we talked with people who use the service, staff, the manager and the area manager. We looked at how staff support the people who live here. We looked at information about the people who use the service and how well their needs are met. Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. The care assessments and plans at Avondale are very good and are being further improved. Newer care records are very detailed and clear. They include a Listen to Me personal profile which sets out the individual preferences, capabilities and needs of each person, and show staff how to support people to achieve goals. Care records are written in the first person, and respect the diversity and individuality of each persons abilities and needs. During this visit staff were friendly and supportive towards the people who live here. Staff engaged individual residents in conversations about their choices and wishes, such as what they would like to do that evening, and what they would like to wear to go out. In this way people are encouraged to make their own decisions. Staff have had training in the mental capacity act, care planning and risk assessments, so they have a good understanding of residents rights to make their own decisions. People are also encouraged to make group decisions at their weekly house meetings. For example, each week everyone is given the chance to make suggestions about the menus for that week. Staff provide pictures and food packaging for people to make their suggestions known, and this supports people with limited speech. Two residents are also involved in the weekly grocery shopping with staff. The home has achieved a 5* Food Safety award (the top mark) from Environmental Health, for its excellent food hygiene standards. At the last inspection a requirement was made about the way in which incoming Care Homes for Adults (18-65 years) Page 4 of 10 medication was recorded. Since then the home has adopted a new medication system that is delivered by a pharmacy. As a result the pharmacy provides the home with preprinted medication administration records (MARs) so staff can clearly check incoming medication. The manager also commented that the medication policy and procedure has been redeveloped. The home has an improved secure medication storage cupboard. All staff have been trained in safe handling of medication,but only designated staff are responsible for administering medication. Two staff carry out administration and audits of every medication at every dosage time. The manager also carries out regular competency checks. In this way residents medication is well-managed, and the risk of any error is now minimised. At the last inspection 15 requirements were made about the poor state of repair of the building and significant premises shortfalls, some of which compromised the health & safety of the people who live here. These included rotten windows, uneven and unsafe flooring, unsafe bath hoist, unsuitable locks to fire exits, and unreliable stair lift. Also all bedrooms required attention to address any damp, rot, draughts, unsafe flooring to ensuite showers, and unreliable water supply. Following that inspection an action plan was received from the provider which outlined how health & safety issues areas had been addressed. A programme of replacement and refurbishment for the other premises shortfalls has been undertaken over the past year, though some areas are still on-going, such as replacing old windows with double glazing. Most bedrooms have been redecorated and refurbished in colour schemes chosen by residents. All bedrooms are very individual and have been highly personalised by each of the people who live here. Bedroom doors have now been fitted with suitable door locks and some residents have their own keys, so that they can keep their room private. During this inspection visit most areas of the building were examined and discussions were held with the manager about the improvements and continuing refurbishment of the accommodation. All previous health & safety issues from the last inspection have now been addressed. However a further health & safety issue was found during this visit, as the unfitted, misshapen floor covering to the communal bathroom is now presenting a significant tripping hazard for residents and staff. Also the stairlift has been removed but has not been replaced. Some people who are accommodated on the first floor have declining mobility, so the home should be continually adapted to meet their needs. Also the lighting to first floor corridors is very dim which could make it difficult for residents and staff to negotiate the split levels of stairs. A number of minor premises shortfalls were reported to the manager for attention. These included rusting shower chairs; cracked bedroom wall; lack of grab rail to en-suite toilet; flaking paint to the laundry room ceiling; and many areas of scuffed, chipped paintwork to skirting boards. It was a requirement of the last inspection that the manager apply for registration under the Care Standards Act 2000. Since then the manager has been registered. She has also attained NVQ level 4 in care management, which is a suitable qualification for the Care Homes for Adults (18-65 years) Page 5 of 10 management of a care service. In surveys some staff commented on the improved management of this service over the last year. What the care home does well: 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 2. Care Homes for Adults (18-65 years) Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 10 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, 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 1 19 23 The premises shortfalls from 11/08/2010 this inspection must be addressed, for example rusting shower chairs, cracked walls, peeling paint to laundry ceiling, and chipped paintwork. This is to make sure that people live in accommodation that is in a satisfactory state of decoration. 2 19 23 The provider must replace the unfitted bathroom flooring with suitable, fitted, non-slip flooring. This is to prevent residents and staff from tripping. The provider must ensure that lighting in all areas of the home is sufficiently bright for residents safety. This is to prevent residents from tripping. 11/08/2010 3 25 23 11/08/2010 Care Homes for Adults (18-65 years) Page 8 of 10 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 22 The provider should continually assess the accommodation and ensure that adaptations are provided wherever necessary to support people with physical or mobility needs. Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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