Care Home: Flaxman Avenue (77) - City of York Council

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What the care home does well The home is clean and comfortable. People have their own bedroom, and a range of equipment is available so they can be assisted to move, safely. Three bedrooms have an en suite shower. The remaining bedrooms have an en suite lavatory and sink. Communal facilities include a special bath, which someone described as `lovely`. The staff are aware that the needs of many people who receive respite care are increasing, or are becoming more complex. A recent donation has meant the service has been able to provide further sensory equipment for the people receiving respite care. For those who have less complex needs, staff try to arrange other activities for them to enjoy. For instance, on our second visit, everyone was going out for tea to the local pub. They were all looking forward to this. One person said `I`m on my holidays now`. People can make some decisions in their daily lives, wherever this is possible, although staff sometimes have to make these on people`s behalf. One person said `I can go to bed when I want and get up when I want. Staff always knock on my door and say `Are you ready for breakfast?`. This shows staff are not forgetting to offer people choices. One person said `I love it here. I go to lots of activities in the day centre. I love the staff, the ladies and the men who stay. I have plenty to do`. The registered manager regularly discusses with her manager what staff resources the service has used, or needs, in order to offer the right support. People and their families and carers have access to the council`s complaints procedure. This is provided in writing, pictorially, and also in other languages if needed. The complaints record showed that the manager listens to complaints, and takes action to put things right. There was also evidence to show that, where trends emerge, these are discussed with the staff team, so they too know where they need to make improvements. One person staying at Flaxman Avenue said `I have no complaints at all`. They continued`They`ve looked after me very well`. The registered manager is committed to the service, and to making improvements for those who live there. She listens to comments about how the service could improve, and tries to balance the resources available, to make sure that each person experiences good outcomes during their stay. What the care home could do better: Before a person unknown to the service is admitted, the staff could check, to make sure that less recent care plans received from their care manager, remain accurate. This is so they can be sure they are giving people the right support based on their current assessed needs. An Individual Service User Plan could always be completed once the person is admitted. This is so the reason for the admission is clear, and that current risks to the person, and how they are to be minimised, are documented, discussed, and agreed with them. This will help to make sure the right support is offered. People`s Individual Service User Plans could be signed and dated by them or their representative, to show that all are aware of, and are in agreement with, the current plan in place, to support them throughout their respite stay. The Individual Service User Plans could also be updated if the person`s needs, or resources available to meet these needs, have changed since their last admission, rather that at the next planned review. People`s chosen social activities and lifestyle could be discussed with them, and also any limits the service will have in supporting individuals in meeting these, before they are admitted. For instance, one person said they were `a bit bored`, and that a request by them to go out at the weekend could not be met. Staff had told them that there weren`t enough of them to go out. A staff member, and some relatives, said the home could do better by providing more activities. One suggested, when asked what the home could do better, `more social activities an access social amenities. Get more sensory equipment and activities in house when going out isn`t possible`. Staff could make sure a second staff member checks and signs that medication charts completed by the service have been completed correctly. This will help to reduce the risk from errors happening. The service could remember that it is their duty to inform the commission when they have received safeguarding concerns, so we know what they have done to make sure the right professionals are informed about these concerns, and what steps have been taken to safeguard people. The staffing levels at the service, and the effect that agency staff with less knowledge of people have on their outcomes, are kept under review, as the needs of the people receiving respite care at Flaxman Avenue become greater and more complex. However, staff need to have sufficient time to complete important tasks, such as writing Individual Service User Plans, and meeting people`s collective social needs. This will help to make sure that people are supported by a consistent staff group that understands their needs well. The registered manager could send surveys to people and their representatives to ask their views about staffing availability, and the activities available, so she has a goodpicture about where they would like to see specific improvements made. She will then be in a better position to understand their views about what the service does well, where it could do better, and to tell people what her plans are in response to their comments. Random inspection report Care homes for adults (18-65 years) Name: Address: Flaxman Avenue (77) - City of York Council 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW two star good service 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: Anne Prankitt Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Flaxman Avenue (77) - City of York Council 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW 01904426428 F/P01904426428 carole.aherne@york.gov.uk www.york.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Ann Aherne Type of registration: Number of places registered: Conditions of registration: Category(ies) : City of York Council care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 6 Flaxman Avenue is registered to provide residential, personal, and social care on a respite basis for up to six adults with learning disabilities. Two of the beds are for emergency admissions and whilst people can be provisionally booked into them as part of their rolling respite programme, it is on the understanding that if an emergency situation arises, the respite stay may be cancelled at short notice. The home is a single storey purpose built property owned by the City of York Council. All of the bedrooms are for single occupancy, three have en-suite bathrooms and three have en-suite toilets. Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home There is currently a six-person day service being run from the lounge at the front of the home. This is staffed separately from the care service and finishes at 3.30pm so does not interfere with the respite care provision in the home. The home is located on the outskirts of York city centre, in a residential area, with good access to the citys services and amenities. There is a large car park to the front of the home and an enclosed garden at the back of the property. The registered manager should be approached for information about fees, and what people pay extra for. The service has a statement of purpose that explains the aims, objectives and philosophies of the home and this is available in alternative formats. The most recent inspection report is made available to anyone who wishes to see it. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: The last key inspection for Flaxman Avenue took place on 11 September 2007. This is a report of the findings of a random unannounced inspection, which began on 27 April 2010, and finished on 28 April 2010. We returned to the service for a second day, because on the first, there was only one person using the service available to speak to, and peoples views are an important part of our evidence. In total, we spent four hours there. We also considered the following evidence: Completed surveys, returned by five people who use the service for respite care. These had been completed by their relative or carer on their behalf. We also received four completed staff surveys. The Annual Quality Assurance Assessment (AQAA). This is a self assessment, completed by the registered manager, which gave us information about how the service thinks outcomes are being met for the people who use it. Previous reviews, called Annual Service Reviews, completed by the commission. Other information received about the service. During our visit to the service, we: Looked around the environment at the communal areas shared by people. One person showed us their room, and we also looked at a room which was not occupied. Talked to a staff member, the registered manager, and some people who were currently staying at Flaxman Avenue for respite care. Looked at some records, including a care plan, the complaints book, some medication records, and a record of meetings that have taken place there. Checked that the requirement outstanding, about medication, had been met. A support worker assisted us on the first day of our visit. On the second day, the registered manager was available, and we provided her with feedback, when we told her about our findings. Overall, the inspection showed that people and their carers are generally happy with the support they receive at Flaxman Avenue. They answered always or usually when asked if the care staff and manager treats them well, and if they listen and act on what they say, and all agreed they know who to go to, and what to do, if they want to complain. We received comments like Great staff attitude with limited resources, Responds to needs generally. Phone contact is good, and staff welcome visits by family members, As a respite home it provides an excellent service. The staff are always very helpful. Flaxman is always clean, and I know who to talk to if I am unhappy with the service provided and Care Homes for Adults (18-65 years) Page 4 of 11 The staff are generally good. People we spoke to also said they like staying at Flaxman Avenue. One said they had No complaints at all. They were going to ask if they could come back soon. We received comments though that some thought the care people get is more consistent when permanent staff are on duty, rather than agency staff, who may not know people so well. One person said agency staff were not always up to the same standard. Another said Staff have a great attitude towards customers. Quality of care doesnt achieve the same standards when agency staff appointed or doesnt appear to. We also received a number of comments that there could be more choice in activities for people. More variety in taking customers out more often...More sensory aspects within the facility, More activities for active young people. Although since these surveys were sent out, we have been informed that more sensory equipment has been donated. There were some areas which we thought could be improved. For instance, to make sure that staff share information effectively to keep people free from avoidable risk. The commission could also be informed about potential safeguarding matters which have been brought to the homes attention. We also thought staff could introduce extra checks when writing down the medication people are prescribed. And the way staff are allocated could be looked at, to make sure that there are enough of them to assist in meeting the social needs of those currently admitted. What the care home does well: The home is clean and comfortable. People have their own bedroom, and a range of equipment is available so they can be assisted to move, safely. Three bedrooms have an en suite shower. The remaining bedrooms have an en suite lavatory and sink. Communal facilities include a special bath, which someone described as lovely. The staff are aware that the needs of many people who receive respite care are increasing, or are becoming more complex. A recent donation has meant the service has been able to provide further sensory equipment for the people receiving respite care. For those who have less complex needs, staff try to arrange other activities for them to enjoy. For instance, on our second visit, everyone was going out for tea to the local pub. They were all looking forward to this. One person said Im on my holidays now. People can make some decisions in their daily lives, wherever this is possible, although staff sometimes have to make these on peoples behalf. One person said I can go to bed when I want and get up when I want. Staff always knock on my door and say Are you ready for breakfast?. This shows staff are not forgetting to offer people choices. One person said I love it here. I go to lots of activities in the day centre. I love the staff, the ladies and the men who stay. I have plenty to do. The registered manager regularly discusses with her manager what staff resources the service has used, or needs, in order to offer the right support. People and their families and carers have access to the councils complaints procedure. This is provided in writing, pictorially, and also in other languages if needed. The complaints record showed that the manager listens to complaints, and takes action to put things right. There was also evidence to show that, where trends emerge, these are discussed with the staff team, so they too know where they need to make improvements. One person staying at Flaxman Avenue said I have no complaints at all. They continued Care Homes for Adults (18-65 years) Page 5 of 11 Theyve looked after me very well. The registered manager is committed to the service, and to making improvements for those who live there. She listens to comments about how the service could improve, and tries to balance the resources available, to make sure that each person experiences good outcomes during their stay. What they could do better: Before a person unknown to the service is admitted, the staff could check, to make sure that less recent care plans received from their care manager, remain accurate. This is so they can be sure they are giving people the right support based on their current assessed needs. An Individual Service User Plan could always be completed once the person is admitted. This is so the reason for the admission is clear, and that current risks to the person, and how they are to be minimised, are documented, discussed, and agreed with them. This will help to make sure the right support is offered. Peoples Individual Service User Plans could be signed and dated by them or their representative, to show that all are aware of, and are in agreement with, the current plan in place, to support them throughout their respite stay. The Individual Service User Plans could also be updated if the persons needs, or resources available to meet these needs, have changed since their last admission, rather that at the next planned review. Peoples chosen social activities and lifestyle could be discussed with them, and also any limits the service will have in supporting individuals in meeting these, before they are admitted. For instance, one person said they were a bit bored, and that a request by them to go out at the weekend could not be met. Staff had told them that there werent enough of them to go out. A staff member, and some relatives, said the home could do better by providing more activities. One suggested, when asked what the home could do better, more social activities an access social amenities. Get more sensory equipment and activities in house when going out isnt possible. Staff could make sure a second staff member checks and signs that medication charts completed by the service have been completed correctly. This will help to reduce the risk from errors happening. The service could remember that it is their duty to inform the commission when they have received safeguarding concerns, so we know what they have done to make sure the right professionals are informed about these concerns, and what steps have been taken to safeguard people. The staffing levels at the service, and the effect that agency staff with less knowledge of people have on their outcomes, are kept under review, as the needs of the people receiving respite care at Flaxman Avenue become greater and more complex. However, staff need to have sufficient time to complete important tasks, such as writing Individual Service User Plans, and meeting peoples collective social needs. This will help to make sure that people are supported by a consistent staff group that understands their needs well. The registered manager could send surveys to people and their representatives to ask their views about staffing availability, and the activities available, so she has a good Care Homes for Adults (18-65 years) Page 6 of 11 picture about where they would like to see specific improvements made. She will then be in a better position to understand their views about what the service does well, where it could do better, and to tell people what her plans are in response to their comments. 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 7 of 11 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 8 of 11 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 37 The service must inform the 15/05/2010 commission about any safeguarding matters referred to the local authority for investigation. This is so we are kept informed about what action has been taken in making sure the right professionals are informed about these concerns, and how people are being protected. 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 2 Before a person unknown to the service is admitted, staff should check, to make sure that less recent care plans received from their care manager, remain accurate. This is so they can be sure they are giving people the right support based on their current assessed needs. Peoples chosen social activities and lifestyle could be discussed with them, and also any limits the service will have in supporting individuals in meeting these, before Care Homes for Adults (18-65 years) Page 9 of 11 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 they are admitted. 2 6 Staff should complete an Individual Service User Plan for each person admitted to the service so staff are all aware of current areas of risk, how it is to be managed, and where people may need support during their stay. Peoples Individual Service Plans should be signed and dated by them or their representative, to show that all are aware of, and are in agreement with, the current plan in place to support them throughout their respite stay. 3 20 Instructions on typed and hand written medication charts should be checked and countersigned by a second staff member. This will help to reduce the risk from errors caused by incorrect entries. It is recommended that the views of people and their families are sought to check what the home does well, and where it could do better, in relation to staffing provision and activities. The collective comments should be considered, when deciding what changes need to be made to improve outcomes for people in these areas. 4 39 Care Homes for Adults (18-65 years) Page 10 of 11 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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