Inspection on 25/04/05 for 1-6 Ashby Court

This inspection was carried out on 25th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1-6 Ashby Court 06/08/07

1-6 Ashby Court 31/05/06

1-6 Ashby Court 17/11/05

1-6 Ashby Court 24/09/04

1-6 Ashby Court 16/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1-6 Ashby Court 1-6 Ashby Court Spilsby Lincolnshire PE23 5DR Lead Inspector Kima Sutherland-Dee Unannounced 25 April 2005 09:30 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 1-6 Ashby Court Address 1-6 Ashby Court Spilsby Lincolnshire PE23 5SW 01790 753432 01754 811004 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Boulevard Care Miss Nicola-Jane Golightly Care Home 11 Category(ies) of Learning Disability (LD) - 11 (eleven) registration, with number of places 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th September 2004. Brief Description of the Service: Ashby Court is a row of 6 terraced houses, owned by the Boulevard Care Group. The houses are 2 bedroom and they are very close to the centre of the small market town of Spilsby. The service can accomodate and support residents under 65 years old with the primary need of learning disability. The homes are aimed towards residents who can live semi independently although at least 2 members of staff are on duty with 2 staff sleeping in on the premises. Each house is decorated and furnished and they are different depending on the preferences and abilities of the 2 residents sharing each home. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of talking with 5 residents, the senior team leader on duty, 1 member of staff and the support manager. Care plans and documents were seen and a tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 6 The home needs to improve the way they administer some medication and the staff need more information about when they give some medicines. The staff must protect the residents from the potential hazard of cigarette smoke. Each of the resident’s views must be listened to and respected and where there is conflict with the staff it would be helpful if independent advocates could be used. The staff need to demonstrate their respect for the views and privacy of the residents by always knocking on the doors of the home before entering. Two residents said that they do not always have enough food and the staff agreed that one resident required encouragement to maintain a healthy diet, so the home owners need to consider whether the food budget for each resident should be increased. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 New residents have the opportunity to visit the home before they move in and their needs are assessed. EVIDENCE: A new resident has been identified at another Boulevard home who is moving to Ashby court in the next few weeks. The support manager said that an assessment will be carried out prior to the move, which will identify their needs and why the move will benefit them. This resident has already visited the home and will continue to do so until they move in. The existing residents know the new resident and they said they get on well. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 The care plans are informative and residents are given choices even though 2 residents disagreed with this. Residents are allowed to take assessed risks in order to increase their independence and the staff have a good understanding of the residents needs. EVIDENCE: The care plans have been improved with information added about the resident’s preferences and how the staff can meet their needs. These are discussed with the residents at reviews and informally with their key-workers. The staff have a good knowledge of the needs of each resident and they put this into practice. The residents said they get on with the staff. The residents described their routines and that they can usually make decisions about what they do. Two residents said they can’t stay in the home themselves therefore they occasionally have to accompany others out when they would rather not. The staff said that although this was the case, pressure was being put on one resident by another and one of them would like to go to these venue’s. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 10 Residents are asked their opinions at meetings and during normal support. There has been an increase in activity for one resident as they now have a mobility vehicle. He said he likes going out, and to his parents home. The care plans had risk assessments for each resident and these are reviewed. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 The residents are supported by the staff and they do take part in varied activities. The staff do not always respect all of the views of the residents, although this is sometimes under provocation. The low weekly food budget does limit their dietry options. EVIDENCE: The care plans demonstrate that the residents are encouraged and supported to develop their skills. The residents said they can go out independently into the town and most of them can organise some aspects of their daily lives independently, such as meals out and hair cuts, and local shopping. The care plans included information about health and personal relationships. The staff have a view about two residents relationship that conflicts with the wishes of the residents and this has caused tension. The same two residents said that the staff do not always respect their views and they can be treated ‘as babies’. Other residents said that the staff listen to them and treat them kindly. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 12 The residents talked about their activities and these were varied and appropriate, they included concerts, swimming , shopping. Two residents have gained local employment part time and they value the additional income. The staff have worked hard to support residents to take part in training and employment. The residents who were not attending the day centre (part of the providers organisation), were going shopping in Skegness for their weekly food. Most of the residents said they enjoyed the food which they plan for with the staff. Two residents said that they did not have enough food and one had been advised to increase their food intake and this was not being supported. The staff said they do encourage this resident with their meals. The staff said they have increased the time they spend supporting residents to prepare their own meals and baking. The weekly budget for a couple is £35.00 and for single person it is £17.50 this has been reduced recently as the company now buys cleaning products and vegetables in bulk. The residents said they have to give the change back to the staff. The staff said this is then used for stock items and for a joint Sunday meal between all the homes. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 EVIDENCE: The residents said that the staff do help them with their personal care. This usually consists of verbal prompting rather than physical care. Two residents said that the staff do not always knock on the door and if they are still upstairs the staff do enter the home uninvited. The residents have independently put up a sign asking everyone to knock. The staff support the residents to maintain their health. Records were seen relating to health appointments and any outcomes. The residents do have the opportunity to manage their own medication where this is appropriate. The medication record showed that a dose of P.R.N ( as required medication) was administered but the home did not have any protocols to say when or why this should be given. The home also holds a stock of homely remedies but the policies did not include a procedure for giving these. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22. The residents are EVIDENCE: The home does have a complaints procedure and the residents are aware of this. The information is included in the service user guide and this information is shared with the residents through talks with their key-workers. The residents said they would go to the staff or to the support manager if they had problems. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,28,30 The homes do suit the needs of the majority of the residents and they are individual according to preferences. The resident in one home is not protected from the risk of smoke, and the residents in one home need further assistance to maintain a clean environment. EVIDENCE: There have been recent improvements and on going maintainence to the homes. Four homes have been repainted and carpet arrived for 1 home during the inspection. Three residents said they had chosen paint colours for their homes and two said they had not had that opportunity, although the staff said they were consulted. The homes vary in their standard of furniture and fittings and some of the kitchen units are looking worn. The staff smoke in the kitchen of the home they use as an office but it is also used by one non-smoking resident. The resident said he ‘didn’t mind the smoke but it did smell’. One resident still has difficulty using the stairs and the providers are looking at options that would better suit his needs. The residents are supported to keep their own homes clean and while some take pride in their surroundings others do not see this as a priority. One home has a problem with ants in the kitchen 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 16 and the staff have tried to eliminate this but they stated that it is an issue when the residents prepare food and do not always clean debris away. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36 The staff team are trained and competent to meet the needs of the residents, they support each other in often difficult situations, and they receive support from the management team. EVIDENCE: The staff have job descriptions and they understand their roles within a team that they say work well together. The staff have the opportunity to undertake suitable training and they receive regular supervision. The support managers visit the home twice a week and the team leader said that they can always contact them for advice. The residents said they like the staff and that they do help them to do the things they want. The staff have a clear understanding of the needs of the residents and they try to follow the management plans for each person. The staff have regular meetings where they discuss how to meet the needs of the residents and offer each other mutual support. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,40. The home is run effectively but would benefit from a full time manager. EVIDENCE: The home hasn’t had a manager in post since January, and although the support managers do supervise the team the home is managed on a daily basis by the team leaders. The residents have opportunities to contribute to the running of their homes through resident meetings, quality surveys and informally on a daily basis. Two residents said they can make their own decisions and chose what they do. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 2 2 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1-6 Ashby Court Score 2 x 2 x Standard No 37 38 39 40 41 42 43 Score x 2 3 2 x x x C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP17 Regulation 16(2)(i) Requirement The home must ensure that all the residents have enough food, in both quantity and quality to meet their needs. The home must develope procedures for giving P.R.N medication and homely remedies. The staff must always respect the residents privacy and use the door bell before entering the homes, except in emergency situations. The home must protect the residents by eliminating smoke from the enironment in 1 of the homes. When the staff are in the homes of residents who smokes they must consult them before smoking. The staff must assist residents in one home to keep the home clean and free of insect infestation. Timescale for action 30th May 2005. 30th June 2005. 30th May 2005. 2. OP18 13(2) 3. OP20 12(4)(a) 4. OP24 & OP30 13(4)(a) 30th May2005. 5. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP16 Good Practice Recommendations The staff should always listen to the views of the residents and take them into account. When there is tension between the staff and residents it would be useful to find independent advocates. 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 1-6 Ashby Court C53 C04 S2596 1-6 Ashby Court V223295 250405 Stage 4.doc Version 1.30 Page 23 - 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. 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