Inspection on 06/12/05 for 4a Ash Street

This inspection was carried out on 6th December 2005.

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

The inspector 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 26/07/05

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 Suzanne Magnier Announced Inspection 6th December 2005 10:00 Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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 Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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 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) New Support Options Limited Miss Clare Twomey Care Home 5 Category(ies) of Learning disability (5), Physical disability (5) registration, with number of places Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Each of the residents has both learning and physical disabilities The age/age range of the persons to be accommodated will be: 40 65 Years of age 26th July 2005 Date of last inspection 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) DS0000013508.V264131.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4.5 hours and was conducted with the Registered Manager. The main focus of the inspection was to ascertain that that the previous requirements and standards not assessed during the unannounced inspection in July 2005 had been met. During a tour of the premises the inspector met with all the residents and members of staff. For the purpose of the report the Registered Manager advised the inspector that the people who live in the home are referred to as ‘supported people’. No comment cards have been received by CSCI regarding the operation of the home. The home currently supports four people who have very complex needs and do not use formal speech to communicate. The environment can be noisy with people communicating in their own way, which could be viewed as challenging, and who need specific understanding of their individual needs. Due to the complexity of the of the lifestyles and needs for the people supported the inspectors observed staff interaction with the people being supported noting communication through tone, eye contact, support interactions and other body language. The inspector wishes to thank the resident’s, staff and Registered Manager for their cooperation during the inspection. What the service does well: What has improved since the last inspection? What they could do better: It is important that the Statement of Purpose and the Service User Guide contain clear guidance that any prospective resident would be able to have a trial period at the home in order to ensure that their needs can be met at the home and they would be able to settle and be happy at the home. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 6 It has been required that choices and wishes regarding the administration of medication and peoples final affairs are documented on behalf of the person. A requirement has been made regarding the supported persons rights to confidentiality of their information. It is recommended that all staff training certificates are made available in the care home. The Registered Manager must undertake a documented risk assessment in order to identify the hazards and actions taken by the care home with regard to one supported persons general bathing needs. Several requirements have been made regarding the health and safety in the home including repair of the leaking bath, removal of rusting wall unit and immediate requirements to repair several fire doors within the property, which were not closing correctly. The home must ensure that documentation of care staff and visiting therapists for example aroma therapists are available within the home to evidence that appropriate recruitment checks, qualifications and insurances have been obtained in order to ensure that safety and welfare of the supported people. 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) DS0000013508.V264131.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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 the following standard(s): 4. Some amendments need to be made to the Statement of Purpose and the Service User Guide. Both of the documents are available to a prospective supported person or their representatives in order to them to make an informed judgement about where they might like to live. EVIDENCE: There have been no admissions to the home since the last inspection and currently the home has one vacancy. The homes statement of purpose clearly sets out the ethos and service provided at the home. The inspector and Manager discussed some small amendments to be made to the Statement of Purpose and the Service User Guide service user. Additionally it is required that both documents contain clear guidance that any prospective supported person would be able to have a trial period at the home in order to ensure that their needs can be met at the home and they would be able to settle and be happy at the home. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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 the following standard(s): 10. A requirement has been made regarding the supported persons rights to confidentiality of information. EVIDENCE: During the tour of the premises it was unfortunate to note that in several of the people’s bedrooms care notes had been attached to walls detailing specific ways to support the person. In discussion with the Registered Manager a requirement has been made that the information is removed from the walls of the room in order to promote the persons right to privacy, dignity and confidentiality and to promote a less institutionalised way of staff communication. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 10 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): 17. The midday meal served during the inspection was wholesome and nutritious with all supported people receiving individual attention from competent staff. EVIDENCE: The kitchen of the home is an open plan style, which enables the supported person to be in safe proximity whilst the staff members prepare the meals. This proximity affords the person to be involved in the sensory experience of the mealtime and the active engagement in the home. During the inspection the inspector observed the serving of the midday meal, which was baked potatoes and an assortment of fillings and pasties. The staff supported each of the four supported people individually in a sensitive and caring manner. It was noted that one person was reluctant to eat their meal and the staff encouraged them respectfully to eat their meal whilst giving them choice. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 11 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): 20, 21. The home operates a robust medication policy and procedure. An improvement has been required regarding the supported persons choice and preferred way to take their medication. A requirement has been made that the staff and Registered Manager, in the absence of another representative document a plan of the persons final affairs based on the supported persons character and personality. EVIDENCE: The homes medication is prepared by the local pharmacy in blister packs. The inspector sampled a recent audit undertaken by the local pharmacy, which was favourable. The storage of the medication was appropriate and organised with regular stock checks undertaken and recorded. The inspector spoke with two staff members who were supporting a person with their medication. The staff members spoke confidently of the medication process and demonstrated the procedure of administering and recording medication efficiently. A requirement has been made that the supported persons individual medication charts contain information as to the preferred way each person Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 12 prefers to take their medication for example with water, milk or yogurt and any difficulties they may experience when having their medication. The Registered Manager explained that some supported people have specialised emergency medication and all but one member of staff has received training in the administration of the medication. A risk assessment and agreed working guidelines for the use of this medication were documented. The inspector sampled the New Support Options policy related to death and dying of a supported person. The Registered Manager explained that due to the complexities of the supported persons needs it has been difficult to ascertain the wishes of the person in their final affairs. The inspector sampled one care plan that with the assistance of the person’s family requests regarding the supported persons final affairs had been documented. A requirement has been made that the staff and Registered Manager, in the absence of another representative document a plan of the persons final affairs based on the supported persons character and personality. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 13 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. All staff have attended training in the awareness of the policy and procedures related to the protection of vulnerable adults. EVIDENCE: The inspector evidenced that the home has obtained the updated local authority Protection of Vulnerable Adults policy and procedures. Following the previous inspection the inspector sampled training certificates, which confirmed the Registered Manager had attended the local authority protection of vulnerable Adults training. Training records for staff indicated that all staff had attended an awareness of the protection of vulnerable adults training facilitated by New Support Options. The inspector observed that the New Support Options training department had not issued training certificates and it has been recommended that these are obtained and made available in the service. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 14 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): 24,25,26,27,28,30. The home offers a clean, homely and comfortable environment. Several requirements have been made regarding repairs and maintenance and the bathing facilities for one supported person. EVIDENCE: The home continues to provide a homely environment and is clean throughout. The inspector made a tour of the premises. All the supported peoples individual bedrooms were well decorated, spacious and personalised to reflect their likes and hobbies. Appropriate bedding, specialised equipment and soft furnishings were noted as available in the people’s rooms. Within some of the bedrooms individuals had their own personal possessions including photos, ornaments, music centres and C.D’s. There was evidence of hobbies for example crafts, painting, and certificates of achievements. The bathrooms and toilets throughout the property were in good decorative order. The inspector noted that one bath was leaking and a metal corner unit within the bathroom was rusting. It is required that the bath be repaired and the rusting corner unit replaced. It was noted by the inspector that for one supported person the bathing facilities were inappropriate as the bath was too Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 15 small to enable the resident to be fully immersed in the bath water. It is required that the Registered Manager completes a risk assessment in order to ascertain the hazards identified and the actions in place to promote the welfare and well being of the supported person. The homes communal areas are homely and comfortable. The Registered Manager explained that the lounge area is due to be decorated in the New Year. The inspector noted that the lounge carpet was heavily stained and a requirement has been made that this is cleaned thoroughly or replaced. The home’s ‘sensory room’ was noted as well equipped and was being used by a supported person during the inspection. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 16 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): 34. Several requirements have been made regarding the recruitment and vetting of people supporting individuals within the home. EVIDENCE: During the inspection it was noted that the staff were attentive, calm and proactive in meeting the complexity of needs of individuals during the inspection. The home currently has several care staff vacancies. The Registered Manager advised that the vacancies are being advertised within the organisation and the vacancies being covered by regular bank staff. The inspector sampled several staff files of staff recently recruited. The staff files evidenced that all documentation was available apart from evidence of a current Criminal Records check having been obtained from the New Support Options human resources department. The Registered Manager advised that the clearance had been sent electronically but had been deleted. The Registered Manager advised that the supported people have one to one sessions with alternative specialists for example providing aromatherapy. The Manager advised that no checks of evidence of current insurance, registration or membership of any professional body had been obtained and a requirement has been made that this evidence is obtained to ensure the safety and protection of the supported person. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 17 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): 37,43. With the commitment and enthusiasm of the Registered Manager and staff the supported people’s best interests are promoted. The inspector received favourable feedback regarding the support the Registered Manager receives from New Support Options. EVIDENCE: The management approach in the home continues to be open and inclusive. The Registered Manager advised that she is currently undertaking the Registered Managers Award and several staff are achieving their National Vocational Qualification NVQ 2 and 3. During the tour of the premises the inspector noted that several fire doors within the home were not closing properly and immediate requirements were made that the doors are repaired. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x 2 x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 2 x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ash Street (4a) Score x x 2 2 Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x DS0000013508.V264131.R01.S.doc Version 5.0 Page 19 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. 1 Standard YA. 4 Regulation 4.(1) Requirement The Registered Person must ensure that the Statement of Purpose and the Service User Guide contain clear guidance that any prospective resident would be able to have a trial period at the home in order to ensure that their needs can be met. The Registered Person must ensure that each individual’s personal information is removed from the cards attached to the walls of their bedroom in order to promote the individuals right to privacy, dignity and confidentiality. The Registered Person must ensure that the residents individual medication charts contain information as to the preferred way each person prefers to take their medication for example with water, milk or yogurt and any difficulties they may experience when having their medication. The Registered Person in the absence of another representative must document DS0000013508.V264131.R01.S.doc Timescale for action 06/01/06 2 YA.10 12.(4) 06/12/05 3 YA.20 12.(2) 13.(2) 13.(4)c 06/01/06 4 YA.21 12.(3) 06/03/06 Ash Street (4a) Version 5.0 Page 20 5 YA.24 6 7 YA.27 YA.27 8 YA.28 9 YA.34 10 YA.34 11 YA.42 a plan of the persons final affairs based on the supported persons character and personality. 23.(2)c The Registered Person must ensure that the rusting metal corner unit within the bathroom is removed. 23.(2)c The Registered Person must ensure that the leaking bath is repaired. 13.(4)(a)(c) The Registered Person must ensure that suitable arrangements including a documented risk assessment is completed with regard to the bathing arrangements for one supported person. 23.(2)(d) The Registered Person must ensure that the heavily stained carpet in the communal lounge is cleaned thoroughly or replaced. 7,9, & 19 The Registered Person must ensure that employment checks for care staff include CRB checks and evidence of clearance is available within the care home. 7,9,& 19 The Registered Person must Sch 2 (9) ensure that visiting professional for example aroma therapists provide details and evidence of current insurance, registration or membership of any professional body to ensure the safety and protection of the supported person. 23.(4) The Registered Manager must (a)(i) take adequate precautions against the risk of fire. The fire doors, which are not closing properly, must receive attention. 06/03/06 06/01/06 06/01/06 06/03/06 06/01/06 06/03/06 06/12/05 Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA.23 Good Practice Recommendations It is recommended that all staff training certificates made available in the care home. Ash Street (4a) DS0000013508.V264131.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office 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) DS0000013508.V264131.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!