Inspection on 26/07/05 for 4a Ash Street

This inspection was carried out on 26th July 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

4a Ash Street 14/10/08

4a Ash Street 15/11/07

4a Ash Street 06/06/07

4a Ash Street 08/12/06

4a Ash Street 06/12/05

4a Ash Street 29/11/04

4a Ash Street 29/06/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Ash Street (4a) 4a Ash Street Ash Nr Aldershot Hampshire GU12 6LT Lead Inspector Helen Dickens Unannounced 26 July 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. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ash Street (4a) Address 4a Ash Street Ash Nr Aldershot Hampshire GU12 6LT 01252 350582 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) New Support Options Limited 9/10 Commerce Park, Brunel Road, Theale, Berkshire, RG7 4AB Ms Lynne Marie Davis Care Home (CRH) 5 5 5 Category(ies) of Learning disability (LD) registration, with number Physical disability (PD) of places Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Each of the residents has both learning and physical disabilities 2 The age/age range of the persons to be accommodated will be: 40 - 65 years of age Date of last inspection 29 November 2004 Brief Description of the Service: 4a Ash Street is a modern bungalow situated just off the main road on the outskirts of Ash Village. A housing association owns the premises and the service is provided and managed by a not-for-profit organisation, New Support Options Ltd. Accommodation and personal care is provided for up to five residents who have both physical and learning disabilities. Each resident has a single room and there is also a kitchen, dining room, living room, sensory room and laundry. There is parking available at the end of the drive next to the home. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. The inspection was carried out by Helen Dickens, Lead Inspector for the service. Sharon Attridge (Senior Support Worker) and Sophie Fullick (Area Manager) represented the establishment. A tour of the premises took place and the inspector met all four residents. One member of staff was interviewed and files and documents were examined as part of the inspection. This was a positive inspection. The inspector would like to thank the residents and staff for their time, assistance and hospitality during this inspection. Direct quotes in the main body of this report have been used with the permission of each person quoted. What the service does well: What has improved since the last inspection? Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 6 The manager is fairly new in post and has made a number of changes and improvements to the service. Administrative procedures have been streamlined and reorganised and staff commented positively on these changes. There have been greater efforts to involve residents in the life of the home and in particular to make choices in their day to day lives; more information about this is contained in the main report. The ‘communication passports’ and other tools devised by the home to assist residents have improved communication between staff and residents and the home should be commended for the efforts they are making in this regard. Requirements from the last inspection have been completed with the exception of the recommendation regarding room numbers which were to be added to contracts; this has been partially completed. 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. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 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 Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 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) 1,2,3 and 5 This home provides sufficient information, in resident friendly formats, which would enable prospective residents to make informed judgements about where they might like to live. EVIDENCE: The statement of purpose clearly sets out the ethos and service available at 4a Ash Street. Residents have their own copy which has been tailored to each resident’s needs in a friendly format. Some residents cannot manage even with a picture format and therefore staff have explained the statement of purpose to them. There have been no new residents since the last inspection but a sample of existing resident’s files showed proper initial assessments had been carried out. The home demonstrated its capacity to meet the needs of existing residents and in particular was excelling in efforts to communicate with them. Each resident had a ‘communication passport’ which set out their own particular communication needs and staff could refer to this when learning how to support each resident. In order to meet Standard 5.2 the contracts between residents and New Support Options Ltd need to state clearly which room each resident is entitled Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 9 to occupy; this should be part of the contract. This was discussed with Sophie Fullick on the day of the inspection and suggestions made about how this might be put in place. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 10 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 and 10 Residents at 4a Ash Street can be confident that their needs and goals are reflected in their individual plans and that staff will support them to be as independent as possible. EVIDENCE: Resident’s individual plans sampled were detailed and identified the health and personal care needs of residents. The main plans were reviewed 3 monthly (exceeding the standard which only recommends 6 monthly reviews) and, in addition, the various aspects of the plans were reviewed in the daily diary of each resident. Therapeutic interventions were well documented. Resident’s plans had been prepared in a picture and word format and staff read these to each resident. Some residents belong to an advocacy group but others, who have no relatives, are yet to find independent advocates to support them. The manager has undertaken to continue to pursue this. However, in other respects staff are working hard to empower residents to make decisions about their lives. Small examples like residents choosing their own breakfast cereals were documented. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 11 On the day of the inspection residents were seen to be included in the working of the home and staff could give examples of how residents ‘helped’. For example one resident helped distribute the clean laundry to other residents. It was placed on their knees as they sat in the wheelchair and the staff member would then take them from room to room to drop off the clean items. Another resident was observing the supper being prepared from a safe vantage point in the kitchen. Risk assessments documented identified risks and any limits to personal safety, and strategies were in place to manage these safely. Residents confidential records were kept confidential and the inspector observed care being taken to keep resident’s files secure. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 12 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 and 16 Staff in this home work hard to ensure that residents maintain fulfilling lifestyles both in the home and in the local community. EVIDENCE: Residents at 4a Ash Street have complex needs, however, the home has, in consultation with residents, devised individual programmes of activity including hydrotherapy, aromatherapy, music therapy and time spent in the specially built ‘sensory room’ or in the garden. Outside activities include rides out in the bus, pub lunches, and trips to local attractions such as Birdworld and shopping. The organisation allows £250 per resident for an annual holiday each year. Finding venues for residential holidays for residents has proved difficult because of their complex needs and this year it was decided, in conjunction with residents, that they would have a number of day trips instead. However, the staff are already investigating residential holidays for next year and hope to provide a choice of venues for residents. Those residents who had families were encouraged to maintain links with Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 13 them, and policies in the home promoted the resident’s rights to have personal relationships. Residents all had keys to their rooms, and staff respected their privacy by knocking on doors before entering resident’s individual rooms. Throughout the inspection staff were observed to be respectful towards residents and included them in what was happening within the home. A budgerigar and a very well kept aquarium were provided for the enjoyment and stimulation of residents. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 14 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 This home offers a good level of health and personal care to residents. EVIDENCE: Evidence from resident’s files showed that their personal care needs had been clearly identified and staff were offering support in a sensitive way. Personal preferences were well documented and specialist support needs identified and recorded. Health needs of residents had been assessed and recognised and staff supported residents to maintain their health. For example, by assisting residents to go to outpatients appointments, and to follow their own programmes of therapy and therapeutic activity. Specialist interventions and outcomes were recorded. Two files examined showed the residents had been prescribed a ‘light box’ in the winter months and clear guidance for its use was also on each file. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 15 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 Residents can be confident that their interests are protected by the home’s complaints and protection procedures. EVIDENCE: There have been no complaints since the last inspection and the inspection log confirmed this. The complaints procedure is read and explained to each resident and they are given their own copy to keep. The local adult protection policy is read in conjunction with the New Support Options Ltd company policy. The latest February 2005 version of the local Surrey policy was available and several senior staff had been on the training course this year. It was not clear on the day of the inspection how this training would be cascaded down to other staff and some staff had not been on an adult protection course for some years. The training record displayed in the office did not clearly state when staff would next receive this training. The inspector will recommend that a clear record of adult protection training be kept and regularly updated for all staff. The procedures for looking after resident’s money was efficient and appropriate and on the day of the inspection 2 of the 4 resident’s personal finance records were shown to the inspector. They were both found to be correct according to the amount of money in each resident’s box locked in the safe. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 16 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) 24,25,26,27,28,29 and 30 The home offers a clean, homely and comfortable environment for its residents. EVIDENCE: The home was accessible and well maintained and provided a homely environment. There were no offensive odours. All residents had their own rooms which were large enough to accommodate wheelchairs and hoists. There was evidence that rooms had been personalised and all were lockable. Suitable toilet facilities were available and two had fixed hoists to assist residents. The shared spaces within the home were accessible to all residents and comfortable. The kitchen/dining area was the focus of activity and this is where the aquarium had been located. The layout meant that staff could chat with residents during the time they were preparing food and attending to domestic chores. The ‘sensory room’ had a number of features specially fitted to stimulate or relax residents and this was used 5 days per week according to staff. Special lighting and varied textural surfaces were examples of the some of the effects available. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 17 Equipment provided to aid resident’s mobility was regularly checked and a selection of safety certificates were examined by the inspector to confirm this. The laundry area was clean and tidy on the day of the inspection and the hazardous substances cupboard locked. The home has no specific storage area for storage/recharging of wheelchairs and equipment, and one unused wheelchair was being stored in the sensory room. Staff said the chair was removed when residents accessed the room but the inspector felt alternative storage space needed to be identified and the unused chair removed completely. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 18 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 and36 Residents can be confident that this home has a strong staff team who are well trained and supervised. EVIDENCE: Staff spoken to were knowledgeable about resident’s needs and aware of their own skill limitations. Policies and procedures identified specialist tasks and which staff were trained to carry these out, for example peg feeding. The inspector observed staff to be approachable and sensitive to resident’s needs – they were communicating well with residents and were respectful towards them. The home is particularly good at promoting mobility and posture and this is well documented on individual plans. Bean bags were provided as an alternative to sitting in a wheelchair for some residents. The staff team at 4a Ash Street work well together. Regular and minuted staff meetings are held and a variety of subjects discussed. So far this year subjects covered have included reviewing medication procedures, making the residents handbook more user-friendly, client issues, administrative matters and health and safety. There are still some staff vacancies at the home but regular bank staff are Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 19 used to make up the shortfall. The staff rota took into account resident’s activities and need for support outside the home. There is a structured induction programme and the file of one recently appointed staff member showed that this was being followed. There was evidence of training for staff on equal opportunities and one staff member had been part of a group looking at diversity within the organisation. The focus was on cultural and ethnic diversity and a special event was being planned to highlight this subject. Training generally was linked to resident’s identified needs and Learning Disability Award Framework training was being undertaken by some members of staff. Staff supervision was documented and staff received 6 sessions per year including an annual appraisal. New Support Options Ltd give staff access to an independent counselling and advice service called the Employee Assistance Programme, and contact details with a number for staff to ring were displayed in the office. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 20 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 and 42 There was an open and inclusive atmosphere in the home, an annual development plan in place and safe working practices were observed. Residents can be confident therefore that the home will fulfil its stated purpose and meet the needs of those who live there. EVIDENCE: The management approach in the home was open and inclusive. Though the manager was not present on the day of the inspection it was clear that there was strong leadership and direction for staff. There was strong commitment to equal opportunities within the organisation. The annual development plan for the home had been translated into a resident-friendly format and one of the resident’s meetings had been dedicated to presenting and explaining this to residents. Notes from other resident’s meetings gave examples of how resident’s opinions were sought on a variety of subjects. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 21 Health and safety were taken seriously by the home and this was reflected in the training available and equipment supplied to assist residents and staff. On the day of the inspection those water temperatures tested by the inspector were around 43C and the two hazardous substances cupboards were locked. Minutes of a resident’s meeting showed how residents had been introduced to the fire safety policy and had then taken part in a fire drill as a practice. Risk assessments were in place and regularly reviewed. A tour of the kitchen also showed the importance given to food health and safety issues. Meat temperatures were recorded, a notice about egg safety was displayed following past scares on this subject, and containers in the fridge had labels noting when each item had been opened. Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 22 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 3 3 4 x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x 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 Ash Street (4a) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 3 x H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 23 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 23.1 Regulation 13(6) Requirement The manager should ensure that all staff have up-to-date training in the protection of vulnerable adults. Adequate storage facilities should be identified for hoists/wheelchairs. Aids which are no longer used should be removed. Timescale for action 26.08.05 2. 29.2 viii 23.(2)(l) 26.08.05 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 5.2 Good Practice Recommendations New Support Options Ltd should state, in the contract with each resident, exactly which room each resident will occupy. Staff should assist those residents without family support to access independent advocacy services. 2. 7.3 Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Ash Street (4a) H58 S13508 4a Ash Street V219198 260705 Stage 4.doc Version 1.40 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!