CARE HOMES FOR OLDER PEOPLE
Ashingdon Road (296) 296 Ashingdon Road Rochford Essex SS4 1TR Lead Inspector
Sarah Hannington Unannounced Inspection 26th April 2007 12.00 X10015.doc Version 1.40 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 Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 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 Older People. 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. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ashingdon Road (296) Address 296 Ashingdon Road Rochford Essex SS4 1TR 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) 01702 541661 F/P 01702 541661 H3047@mencap.org.uk www.mencap.org.uk Royal Mencap Society Ms Carol Rule Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th March 2006 Brief Description of the Service: 296 Ashingdon Road is a two-storey family home in a residential street in Ashingdon, Southend. It is situated close to local shops and amenities and a bus service runs regularly past the home. A railway station is nearby. The home has three single and one double bedroom for residents on the first floor as well as the staff sleeping in room, and a single room on the ground floor. There are sufficient bath and toilet facilities on both floors. There is a large kitchen and living/dining room. The garden is well maintained and of ample size. Residents are encouraged to take an active role in the maintenance of the garden. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Key site inspection site visit took place over a period of 2 hours. During the Inspection 4 support workers were present throughout the inspection process. A tour of the home took place. Staff and service users were spoken with during this inspection. The visit mainly focused on all Key standards and all of the requirements from the last inspection report. Random samples of records, policies and procedures were inspected. Additionally a further two hours were spent gathering information on survey were sent out by CSCI to staff, relatives, service users and others professionals who come into contact with this service. What the service does well:
Person centred planning is in place and the staff actively try to get the wishes, hopes, dreams and goals of individuals fulfilled as much as possible. The manager and team are running a warm, relaxed and welcoming environment. Although the manager or senior staff were not present for this site inspection, the staff team evidenced they were experienced, confident and had a good knowledge of the individual service users, the home and organisation. The staff evidenced that they were flexible to enable individuals in their care to experience choice and encourage independence as much as possible. The service users look well cared for and observation showed that staff are caring and that residents are listened to. Service users have expressed that they are treated with respect and equally by the home supporting personal relationships, encouraging independence as much as possible and ensuring they know their rights. Service users all expressed that they felt the service they received is to a good standard. Staff were seen to be dedicated in ensuring residents retained skills and independence. The choice of meals was nutritious reflected residents choice. Alongside the annual Quality assurance survey carried out by the organisation, the home uses multi-media films as a forum to evidence that the quality of service is promoted and maintained. Whilst on inspection a short film that had been made with the involvement of all service users, families and professionals in contact with the service was shown. All comments on this film were positive and praised the service, staff and care received. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 6 Additionally survey’s sent out by CSCI to staff, relatives, service users and others professionals, evidenced that all parties are happy with the standard of service provided by Ashingdon Road. All surveys returned were complementary. One survey sent out to a relative commented: ‘ The care home where my brother lives, I must say is the best. I live with the knowledge that my brother is in safe hands and is well looked after and I mean well looked after!’ 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. The summary of this inspection report can be made available in other formats on request.
Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Ashingdon Road demonstrated that it has procedures, which meets the needs of individuals prior to admission. EVIDENCE: Policies and procedures are in place regarding pre admission activity such as a prospective service user visiting the home and assessments to be carried out prior to them moving in. The last service user to be admitted was June 06, pre-admission and initial assessments were evidenced in their file. There was evidence that this service user had been offered visits to the home and an overnight stay prior to admission.
Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 9 Some of the comments by residents on surveys sent out and speaking with residents on the site visit, confirmed that they were offered various visits to the home and consultation before moving in. Intermediate care is not provided. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Health Care plans are to a good standard and evidenced there has been some involvement of residents, professionals and most families whilst gathering or reviewing care plans. EVIDENCE: Health care plans are to a good standard and are reviewed regularly, other professionals are involved when necessary. In team meetings individual care and issues are discussed. Recording of appointments and information and general sharing of information amongst the team is to a good standard. Risk assessments and the reduction of risk are to a good and reflect what is written in the care plans. Included within care plans are the preferences of service users and their choice of routines as much as possible. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 11 A policy and procedure is in place for the correct receipt, recording, storage and handling, administration and disposal of medications. Staff mainly support service users to administer medication. One service user administers their own medication and this is supported to a good safe standard. As part of this inspection medication administration records were looked at and no omissions in the recording was noted. Any medication changes had been recorded accurately. Service users spoken with felt that staff in the home supported them as much as possible in making choices and carrying out their goals. This was also evident in paperwork looked at within service users files. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this area excellent. This Judgement has been made using available evidence including a visit to this service. The home has an excellent approach to family involvement, advocacy, information sharing and personal relationships which are important to service users. Advocacy is offered on a monthly basis to further support autonomy and preference. Overall interaction and involvement in the service users lives is to a good standard. There is also a good standard of service users having choice of activities and involvement within the community. EVIDENCE: The home evidences through Care plans, service users views that personal autonomy and choices are promoted and staff are proactive within this area. During inspection staff interaction with service users was observed to be caring, appropriate and supportive. The care plan has a ‘holistic’ approach and covered all areas of a person’s life which you would hope to be included such as preferences, safety, health, communication, spiritual, education and what individuals could/could not or should be encouraged to do. Risk assessments in general were of a good
Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 13 standard. All risk assessments were recorded appropriately, signed for and dated. An infringement of rights is in place for those service users who need them. All service users are supported to carry out daily, weekly routines, such as cleaning, shopping for food, cooking meals, washing of their clothes and maintaince of the garden. There is also a pet rabbit which one service user takes responsibility for. Service users do a number of different community and inside activities, one resident carries out voluntary work within the community a couple of times a week. The home is planning to find one service user employment after this was identified as one of their goals. Ashingdon road also supports two service users that are married and a service users who has a partner who lives outside of the home. Service users families, friends and partners are encouraged to have contact and no restricted visits. Ashingdon Road promotes a high standard of citizen’s rights, equality and diversity. Ashingdon Road has plans to build a conservatory that will support individuals to experience activities they wish to do outside of the initial home environment space. On surveys sent out to residents some people commented that activities were planned, offered and they were given choice and if they wanted to change their plans on the day they could do so. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The manager and staff of the home work closely with families. Staff are having regular supervision and regular staff meetings. EVIDENCE: Service users spoken with knew how to make a complaint and who to. Survey completed by residents evidenced they knew the complaints procedures. No complaints have been recorded within the home or made to the CSCI since the last inspection. A good policy and procedures around complaints are in place. Complaints procedure is included with the service users contract, service user guide and statement of purpose. Training in the protection of vulnerable adults from abuse and mandatory training is in place for all staff. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The home in general is clean and hygienic with no apparent odours. Service users bedrooms provided a good amount of space, individuals had specialised equipment if needed and are personalised according to taste. EVIDENCE: Policies and procedures for infection control are in place. The laundry room is adequate for service users needs and a COSHH cupboard is in place. The manager has got decorating quotes and a maintenance plan for the redecoration in some of the communal areas of the home. The hallway and bathrooms have recently been re-decorated and made good. The garden looks smart, appealing and adds to the homes overall appearance.
Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 16 Service users rooms are clean, personalised and service users spoken with informed me they had had a choice in choosing colour schemes for their rooms. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The number of staff on duty, their experience and skill was able to meet the needs of residents. Staff spoken with felt that they are supported through the management structure and support from supervision and staff meetings. EVIDENCE: The home has an experienced well-dedicated staff team in place. At the time of inspection, the home was fully staffed and the skills mix of the staff group was being used positively in meeting the various needs of residents. The manager has developed a system where as staff-training certificates are kept in one place so all certificates are available for inspection. Staff spoken with confirmed that regular supervision and staff meetings go ahead. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this area is excellent. This Judgement has been made using available evidence including a visit to this service. The Organisation has a good Quality Assurance Package in place. There is a good financial policy and procedure in place. Looking at paperwork and through discussion with individual residents and staff evidenced good teamwork and clear leadership skills from the management in situations that are both sensitive and complicated. EVIDENCE: Service users are benefiting from a strong management and staff team, the level of service is good. The organisation has been proactive in having a good quality assurance process is in place. Recording of minutes, regular meetings, addressing issues raised in the different services and an action plan were
Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 19 present. The home has developed a quality assurance survey that will allow individuals or their representatives to give appraisal of the service, staff and environment provided. Regular support of staff is continuous and service users views underpin the philosophy of the home. Policy and procedures that are put into place reflect the service user group that the home caters for. Health, safety and welfare of service users and staff have been made a priority. All health and safety checks inspected were up to date. Service users are benefiting from a strong management team and the level of service is of good quality. Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 4 Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashingdon Road (296) DS0000018068.V342350.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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