Inspection on 17/01/06 for 134 Ashland Road

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

134 Ashland Road 01/08/06

134 Ashland Road 02/09/05

134 Ashland Road 31/03/05

134 Ashland Road 28/02/05

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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 18-65 134 Ashland Road Sutton In Ashfield Nottinghamshire NG17 2HS Lead Inspector Susan Lewis Unannounced Inspection 17th January 2006 10:00 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 1 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 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 2 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 Stationery 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. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 134 Ashland Road Address Sutton In Ashfield Nottinghamshire NG17 2HS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01623 401668 01623 401668 cherry.ackroyd@ncha.org.uk www.ncha.org.uk NCHA Mrs Cherry Ackroyd Care Home 10 Category(ies) of Learning disability (10) registration, with number of places 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users shall be within category LD Date of last inspection 2nd September 2005 Brief Description of the Service: 134 Ashland Road West is a purpose built bungalow providing personal care and accommodation for up to ten adults with learning difficulties who may have additional physical disabilities. The home is situated in a residential area, close to the town centre amenities of Sutton in Ashfield. The home has its own vehicle, which enables residents to access a variety of activities. Two of the service users are over 65, and are therefore outside of the registration category. However, as they have been resident at the home for a number of years, conditions of registration were set to ensure that their needs could be met within the home. These have now all been complied with, including staff training in care of older people with learning disabilities. The accommodation is homely and comfortable and has recently been refurbished. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is the second unannounced inspection and was carried out by one inspector during the course of 4 ½ hours. Staff files were requested from Nottingham Community Housing Association head office but access was refused. This matter will be followed up at a later date with the registered person. A partial tour of the building took place and all communal areas were viewed as well as a selection of residents’ bedrooms. Staff were spoken with but the residents were spoken with informally. Staff training records were inspected and residents’ care records were viewed. What the service does well: What has improved since the last inspection? What they could do better: 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. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 7 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 the following standard(s): 4 and 5 Prospective residents are provided with the opportunity to try the home before making a decision to move in. Not all residents have relevant contracts for where they live. EVIDENCE: It is the Nottingham Community Housing Association policy to ensure that all prospective residents are enabled to have trial visits before making a decision to move in. On the day of the inspection the home had had no vacancies for some time and therefore had not provided any trial visits. It was also noted that a number of residents who had transferred from another Nottingham Community Housing Association home still had their previous contract and this made reference to their old bedroom not where they currently lived. The registered manager must ensure that all residents have an up to date contract that reflects where they live and they are supported in understanding it. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 8 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 the following standard(s): EVIDENCE: The core standards were inspected at the last inspection and no requirements were set. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 9 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 the following standard(s): 14 and 17 Opportunities for leisure activities are varied and appropriate. A healthy diet is offered. EVIDENCE: Support plans viewed for the purpose of this inspection provided information regarding residents’ activities and how they were encouraged to pursue their choice of activity. During the day staff were seen supporting residents in a variety of choices including going shopping. Evidence was seen that residents are supported to go on holiday and staff spoken with said that this is discussed with residents in 1:1 days and reviews were seen that made reference as to whether a holiday had been successful or not. Although a meal was not seen in preparation as many residents were out taking part in their chosen activity, evidence was seen that balanced healthy meals were provided and the fridge and freezer were well stocked. Fresh fruit and vegetables were available for residents. Staff were able to say how residents made meal choices and records were seen where residents had chosen an alternative. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 10 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 the following standard(s): 18 and 21 Personal support needs are met. Staff would benefit from further training with regard to the ageing process of residents with a learning disability. EVIDENCE: Support plans viewed provided detail of how residents preferred their care to be provided and where residents had limited verbal communication abilities, pans described what abilities the carer should use to ensure the appropriate care was provided. Residents were able to choose what time they wished to get up and go to bed. This was evident on the day of the inspection as a number of residents had chosen to stay in bed and although staff were checking them from time to time they were not insisting they got up. Any restrictions placed on the resident were detailed in the plan providing information linked to a risk assessment as to why this restriction was necessary. All residents had designated key workers and staff spoken with who acted as key workers understood their role and the importance of providing a consistent service. Evidence was seen on support plans that relatives had been asked about their wishes should their loved one become ill. Only one plan had information relating to this, as it would appear that relatives had not replied to this request. The registered person must follow this up. There are a number of residents at the home who are over 55 and staff spoken with said they would benefit from more training regarding working with older people with learning disabilities. It is recommended that the registered person pursue this with staff to ensure they feel confident in providing the care those residents needs. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 11 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 the following standard(s): 23 Residents are protected from abuse by policies and procedures and staff understanding. EVIDENCE: Staff spoken with were able to discuss with understanding what constituted adult abuse and confirmed that some training had taken place. Staff spoken with said they felt confident to both challenge poor practice amongst colleagues and raise it with management. The home has a copy of the Nottinghamshire Protection of Adult Abuse Procedures as well as Nottingham Community Housing Association’s own procedure. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 12 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30 A homely environment is provided which is mostly safe and comfortable. The internal environment meets the needs of the residents and sufficient toilet and washing facilities are provided. The external maintenance places residents at potential risk. EVIDENCE: A requirement was set at the last inspection regarding the pathway to the exterior of the home, as it was potholed and potentially a hazard to residents. This work has not taken place and as such the requirement is not met. The home has recently undergone a refurbishment and residents’ bedrooms are all of a good size allowing any resident with a mobility need, enough space to move freely around the room. The home is bright and clean and as is in keeping with the local community so as not to stand out from other properties in the area. The home is well furnished to a good standard being of both good quality and homely. The bedrooms are personalised and reflect the individual interests of the resident. The selection of bedrooms seen provided residents with comfortable chairs, sufficient electric sockets to minimise the risk of trailing cables, wash hand basins and enough bedroom furniture to meet their needs. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 13 During the recent refurbishment the number of assisted bathrooms and showers was increased. This now ensures that no more than three people share facilities. The shared space has also been refurbished creating a pleasant homely environment. The kitchen and laundry facilities are domestic in character enabling residents to participate in those activities if they so wish. Where residents have physical needs the home is equipped to meet these. The kitchen has been fitted with an adjustable height work surface to enable any resident who is a wheel chair user to be able to participate in food preparation. The home is clean and has good infection control procedures to minimise the risk of infection developing in the home. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 34, 35 and 36 Staff receive regular training and supervision ensuring resident benefit from knowledgeable staff. Recruitment practice could not be checked due to the refusal to provide staff files. EVIDENCE: Staff files are held centrally at Nottingham Community Housing Association head office a request was made to see these recruitment files and it was refused. This is a serious matter and will be taken up with senior managers of NCHA. Staff training files were viewed and showed that staff had attended a variety of training that supported them in their role. Staff spoken with confirmed that they were encouraged to attend training but also that some of the courses were very popular and it was difficult to get places, particularly in specialist areas such as Autism and Aging and Learning Disabilities. All staff who come to work for Nottingham Community Housing Association attend a two-week block induction that takes them through the competencies and skills needed to work with people with learning disabilities. All staff receive a job description and a copy of the General Social Care Council code of conduct ensuring they are aware of what standard they are expected to work to. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 15 Staff spoken with said that they felt that the staff at the home worked well together as a team and that sickness and staff turnover were relatively low enabling consistency of work with the residents. Staff receive regular supervision that looks at their personal development needs and monitors their work with residents. Staff spoken with confirmed that felt well supported by management with their regular supervision. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 and 42 Management of the home is open and policies and procedures are in place to ensure that staff provide a good quality service to residents. EVIDENCE: The manager recently was registered by the Commission for Social Care Inspection as ‘fit person’ to manage the home. Staff spoken with said that the manager gave clear guidance as to the standard of care expected and was supportive and open in her style of management. The Nottingham Community Housing Association have a quality assurance system that ensures each home is audited annually to ensure it is providing quality care. However the responsible individual is supposed to ensure that a monthly visit takes place and a copy of this report is sent to the Commission. This has not been taking place. The Registered Person must ensure that this regulation visit is carried out. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 17 The Nottingham Community Housing Association has a number of policies and procedures. These are regularly reviewed and updated, however it came to the inspector’s attention that the volume that covered financial practice within the home had a chapter entitled ‘Idiots Guide’. This is offensive and good practice would point to this title being revised. It is strongly recommended that the registered person look at revising this. Information regarding the running of the home is well maintained and accessible but secure, staff spoken with confirmed that when residents’ files need to be up dated they spend time with the individual and record the residents’ views. A requirement was set at the last inspection regarding fire doors being wedged open by staff. There was no evidence of this practice taking place during this inspection and the requirement is considered met. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 18 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 Standard No Score 1 X 2 X 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X 3 3 3 2 3 3 3 X 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 YA5 Regulation 5 Requirement The Registered Person must develop a standard form of contract for the provision of service and facilities by the registered provider to service users; that is more applicable to the needs of residents with a learning disability. Timescale for action 01/04/06 2. YA24 13 3 YA34 Sch2 01/03/06 The registered person must ensure that all parts of the home that residents have access to be free from hazards to their safety. The pathway in the garden must be repaired. The Registered Person must 01/02/06 make available to the inspector staff recruitment files containing two references and evidence of a Criminal Records Bureau check. 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 20 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 YA21 Good Practice Recommendations The Registered Person pursue staff training in the area of aging and learning disabilities to ensure staff feel confident in providing the care those residents need. Revise the chapter in Volume 2 of Financial policies and procedures entitled ‘Idiots Guide’. 2 YA40 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 134 Ashland Road DS0000008619.V271815.R02.S.doc Version 5.1 Page 22 - 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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