Inspection on 17/05/05 for 29 West Ashton Road

This inspection was carried out on 17th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

29 West Ashton Road 26/06/07

29 West Ashton Road 10/10/05

29 West Ashton Road 06/10/04

29 West Ashton Road 28/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 West Ashton Road (29) 29 West Ashton Road Trowbridge Wiltshire BA14 7BJ Lead Inspector Malcolm Kippax Unannounced 17th May 2005 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. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service West Ashton Road (29) Address 29 West Ashton Road Trowbridge Wiltshire BA14 7BJ 01225 766654 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) Royal Mencap Society Susan Grace Carwithen Care Home 6 Category(ies) of 6 LD Learning Disability registration, with number of places West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No more than 6 service users with a learning disability which includes the 1 named male service user with both a learning disability and physical disablement currently being accommodated Date of last inspection 8 November 2004 Brief Description of the Service: 29 West Ashton Road provides accommodation for up to six service users. The home is a two-storey Victorian semi-detached property in a residential area of Trowbridge. Mencap is registered as the care provider and the property is owned by the New Era housing association. Each service user has their own room. Two bedrooms are on the ground floor and four rooms are on the first floor. There is a lounge and a dining room. Service users can use a domestic type kitchen and there is a separate utility room with laundry facilities. There is a large lawned garden to the rear of the property. Mrs S. Carwithen manages a staff team of support workers. Staff members provide support for service users in all aspects of their lives. Service users attend a range of college course and day activities in the community. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 1.50pm and took place over three and a half hours. Initially, two service users were at home and others came back during the afternoon from their different activities. On returning home, the service users quickly settled into their own routines, mainly spending time in their rooms or watching television in the lounge. Five service users and two members of staff were spoken to. The communal rooms and three bedrooms were seen. Some records were examined, including three of the service users’ care records. What the service does well: What has improved since the last inspection? What they could do better: Service users like to receive information about things that affect them and work should continue to produce this in different formats. One service user said that he did not have a copy of his care /support plan but would like to have one that he could keep in his room. Service users would like to have extra staff working at the weekends so that they can go out more. A budget should be available to help service users with the cost of holidays. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 6 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. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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 West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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) 4 Prospective service users can get to know the home before moving in. The current service users are consulted and can give feedback about a prospective service user. A new service user would have a settling in period and be given time to decide whether they wished to stay at the home on a permanent basis. EVIDENCE: There was one vacancy. A prospective service user had recently visited the home and had an overnight stay. Service users and staff had met with the prospective service user and talked about whether they would like this person to move in. This and other events are discussed at regular house meetings. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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 and 9 Individual plans are providing a clear summary of the support that service users need. They are well monitored and kept under review by keyworkers. More could be done to produce the plans from a service user’s perspective and to present them in a user-friendly format. Service users are well consulted through individual review meetings and regular house meetings. Service users benefit from a management and organisational approach that encourages participation and inclusion. The atmosphere and the approach of staff encourage service users to treat the home as their own and to act independently. Risk assessments are helping to ensure that the service users can do this safely. The records do not show that all staff are familiar with the outcome of the assessments. EVIDENCE: Individual care and support plans had been reviewed in the last six months and were dated accordingly. The plans were readily accessible to staff but the service users spoken to did not have a copy of their own plans. Comments from service users confirmed that they are able to follow activities and routines without any undue restrictions. Following assessment, some West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 10 service users are able to go out by themselves. One service user said that he went out every morning to collect a newspaper. Minutes are kept of the house meetings; these showed that service users’ views are listened to and that they like to take an active role in the home’s routines. Risk assessments are linked to the care and support plans. Staff are asked to sign a form to confirm that they have read the assessments, although this is not being done consistently. In some cases, the plans and assessments have been re-dated, rather than added to and separately dated. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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) 12, 13, 14 and 16 Service users have the opportunity for both planned and unstructured activities of their own choice and have good community and social networks. The arrangements for meals reflect individuals’ personal choices and encourage service user involvement. The house meetings are a good way in which service users can discuss their activities and what they want to do. Service users receive support in the planning of holidays although support with funding is not provided. Service users receive support from staff who respect their rights and encourage participation in the community. EVIDENCE: Most service users were out during the afternoon doing different things. These included college courses and a drama event. One service user was going out for an evening picnic in connection with his Church. Another service user said that he was intending to find a job in the near future. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 12 One service user was cooking vegetable curry for the tea meal. An alternative would be available if needed although the menu is based on a selection of meals that are popular with service users. There is a written rota for the domestic tasks. The house meeting minutes show that a range of topics are talked about, including social events and holidays. There has been some discussion about the funding of holidays. There is no holiday budget and service users’ need to fund these themselves. However the home’s Statement of Purpose says that a holiday is provided. Information about the recent election was displayed in the front hall. Some service users said that they had voted. One service user was looking forward to going to a Mencap service users’ forum in Birmingham, where he would be representing service users from the South West region. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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 and 19 Service users receive the level of care that they require and are well supported by staff with their healthcare. Staff members monitor the service users’ day to day health and ensure that service users have regular check ups. EVIDENCE: Service users said that they were happy with the arrangements for their personal support. The care / support plans show the areas in which support from staff is required. These have been updated to reflect recent changes in a service user’s needs. Staff support with personal care is usually limited to encouragement and advice. Appointments with dentists, GPs and chiropodist are well reported in the service users’ personal records. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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 and 23 Service users are aware of the home’s complaints procedure and know who they can contact if they have any problems. They are encouraged to share any concerns and these are listened to by staff. Staff members have an understanding of abuse and of the procedures to follow, which helps to protect service users. EVIDENCE: Mencap has produced a complaints procedure in different formats. Service users had information in their rooms and a guide to complaints was also displayed in a public area. There is written guidance for staff about recognising abuse and what to do if abuse is suspected. Staff members spoken with were aware of the local arrangements for following up allegations of abuse. A copy of the ‘No Secrets’ guidance booklet was readily accessible in the home’s office, although not all staff had signed a form to confirm that they had read this. Mencap organises ‘Protect Me’ training, which covers abuse awareness. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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, 25, 28 and 30 Service users benefit from the home’s proximity to local activities and amenities. Service users’ bedrooms suit their needs and the communal areas are well used. The home is generally homely and well decorated. Decoration, furnishings and facilities are generally well maintained however the downstairs bathroom is not a pleasant area for service users. Service users appreciate the garden as a recreational area and there is good potential for further development. Suitable fire precautions are in place. EVIDENCE: Service users know the local area well and spoke about the journeys that they make to their activities in the community. Some of these are within walking distance and others involve public transport, or use of the home’s own transport. Service users were using their own rooms as well as mixing with others in the lounge and the dining room. The lounge is comfortably furnished and has a West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 16 television and video. A separate dining room is available for individual and quieter activities. The service users’ rooms vary in size and outlook. The three rooms seen were well personalised and one service user was busy organising the space after a shopping trip for various items to go in his room. Another service user enjoys drawing and painting and has good space for this in his room. Service users like the new furniture that has been provided in the lounge. Standards of décor are generally good although some fittings in the bathroom are showing wear and tear and the room itself suffers from a lack of natural ventilation and limited space. The upstairs shower room is in good order. Records showed that refurbishment of the bathroom is being discussed with the housing association that owns the property. Of the service users spoken to, one person in particular said that they were keen on the garden and had produced some designs that he would like to see put into practice. The home’s fire log book was up to date, although the dates on which staff members receive instruction need to be added to the record. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.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) 33 Service users enjoy good relationships with the staff team who are appropriately supported and supervised. Service users appreciate the support that they receive but would like to see more staff on at certain times. Recent permanent appointments to the staff team have been successful and reduced the need for service users to receive support from relief and agency staff. New members of staff receive a thorough induction when starting in the home. This helps them to develop a good understanding of the service users’ needs and work consistently with established members of the staff team. Staff members meet on a regular basis and focus on the service users’ current needs and welfare. EVIDENCE: There was positive interaction between staff and service users, when working together in the kitchen and in passing conversations. Two new support workers have been appointed since the last inspection and both were working at the time. One of staff members spoke about their induction, which involved a gradual introduction to work and responsibilities. The staff team has one male member of staff and one service user said that he would like there to be more male staff. Another service user would like more staff to be on at the weekends so that people can go out more. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 18 A staff rota showed a minimum of one member of staff working throughout the day and ‘double cover’ at particular times. At weekends there are two people working for a middle shift on one of the days. Staff members were taking an interest in what the service users were doing and were helping with various arrangements for the afternoon and evening. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 19 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) 37 and 39 There has been a smooth transition in the management of the home. The approach of the manager and staff team appears appropriately focussed on the welfare of service users. Quality assurance includes good consultation with service users. The views of service users and others contribute to an annual development plan for the home. Other ways of involving service users are being looked at. EVIDENCE: Mrs Carwithen has been registered as the home’s manager since the last inspection. Mrs Carwithen has several years’ relevant experience working for Mencap. The minutes of staff meetings show that the needs and welfare of service users are being kept under review and well discussed. ‘Service user inclusion’ was talked about at a meeting in March 2005 and ideas were put forward about how this could be improved. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 20 An annual development plan shows the areas in which service users can be involved. These include staff interviews, the national forum, house meetings, annual reviews and goal plans. West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 21 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 x x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 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 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 West Ashton Road (29) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 22 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 14 Regulation 6 Requirement Timescale for action BY 17/06/05 2. 24 23 The current arrangements for the funding of holidays must be accurately reported in the homes Statement of Purpose The Commission must be notified BY of the action being taken to 17/06/05 refurbish or to relocate the downstairs bathroom 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. 2. 3. Refer to Standard YA6 YA6 YA24 Good Practice Recommendations That any changes in the care plans and risk assessments are made by adding new comments, e.g. to a review section, rather than by amending the existing record That copies of the service users plans are produced in a more user friendly format and available for service users to keep in rooms That service users have as part of the basic contract price the option of a minimum seven-day holiday outside the home West Ashton Road (29) D51_S28350_WESTASHTONRD_V228132_170505Stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN12 2BB 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. 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