Inspection on 08/05/07 for Ahava

This inspection was carried out on 8th May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ahava 17/01/06

Ahava 09/08/05

Ahava 25/01/05

Ahava 28/09/04

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

CARE HOME ADULTS 18-65 Ahava Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ Lead Inspector Kate Harrison Unannounced Inspection 8th May 2007 10.00 Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 Ahava DS0000011409.V330808.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 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. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ahava Address Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ 01344 755592 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) bucketsandspades@norwood.org.uk Norwood Ravenswood Ltd T/A Norwood Mrs Janet Louise Pell Care Home 6 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (1) of places Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/01/06 Brief Description of the Service: Ahava is one of 16 homes for adults with learning difficulties located at Ravenswood Village, and owned and run by Norwood Ravenswood Village. Ravenswood Village provides a culturally appropriate environment for Jewish individuals, and accepts non-Jewish individuals who are happy to be part of a Jewish service. The Village is set in 125 acres of Berkshire countryside, and a wide range of activities is provided. Ahava provides accommodation for six men in three first floor self-contained flats. Each flat has a kitchen, bathroom, lounge/diner and two bedrooms. There is a staff office based in one of the flats. The accommodation and staff deployment supports the semi-independent living arrangements for the men who live there, and are the responsibility of the registered manager. The fees range from £38,310.03 to £54,285.53 per annum. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was an unannounced key inspection, and was a thorough look at how well the service is doing. The inspector arrived at the service at 10.00am and was in the home for seven hours. The inspection took into account detailed information provided by the manager of the home, and any information that CSCI has received about the home since the last inspection. The inspector saw most areas of the home and looked at records and documents relating to the care of the individuals living at the home. The inspector asked the views of the relatives about the home through questionnaires that the Commission had sent out through the home. Five replies were received, and all gave very positive comments about the management of the home. The inspector met the six individuals living at the home during the inspection, and spoke to them about their lives at the home. Time was also spent observing the care staff members interacting with the six individuals, and in visiting some of the community facilities. The inspector also discussed recruitment and safety issues with the responsible members of staff. What the service does well: The village setting provides a community backdrop to the home, where the individuals can work, learn and develop their own relationships as they wish. The village environment helps the individuals to develop good skills, particularly in personal and social relationships, and supports them to become self-confident assertive individuals. People living at Ahava are provided with an excellent range of opportunities in physical activities, so that they can try out and choose from a wide variety of activities. The individuals can discuss ambitions and aspirations, and are supported by skilled staff members to try to achieve their ambitions. Staff members understand that they need to make time to listen to and hear what individuals want to say, so that concerns are dealt with quickly. Relatives believe that the home supports individuals to live the life they choose at the home. The diverse needs and potential of all the individuals at the home are recognised. The home provides a safe and enabling environment for the six individuals living there. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 6 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. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. The individual’s needs are assessed before admission, and the individual is supported to make a decision about moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One individual had recently moved to Ahava from another home within the village. The individual directed the process, made a trial visit to the home and had several overnight stays before the final decision was agreed. The care manager and the managers of both the homes contributed to the decision making process, as did the individuals already living at the home. The manager carried out an assessment about the needs of the individual based on history and experience during the trial stay, and, following the trial visits the individual made it clear that he was going to stay at the home. The individual has settled well at Ahava, and continues to have his needs met and his aspirations encouraged. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. The individuals’ care plans show that they are encouraged and supported to take reasonable risks as part of independent lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the individuals have been living in the village for several years and all have care plans to make sure their needs are met. The village setting provides the individuals with a wealth of opportunities, and the individuals recognise their right to make their own decisions, and are supported by the staff members to manage their timetables for work, activities and education. The individuals are supported to take reasonable risks, within the village and in the wider community. The diverse needs and potential of all the individuals are explored, and opportunities are sought to enable each individual’s potential to be fulfilled. The organisation is developing more person-centred care plans, and is introducing a standardised way of recording information. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. People living at Ahava are supported to make the most of the excellent opportunities available to them locally, nationally and internationally, and, as a consequence, individuals are confident and outgoing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individuals at the home are able to take part in an extensive programme of local and international activities, usually organised by the Recreation and Leisure Department. Activities are published in the monthly village magazine and verbally explained to individuals as necessary. Within the village there is a programme of events in the different areas, such as the village farm, the computer centre, the café, shop, crafts and there is also a variety of different physical activities. Most of the individuals at Ahava have achieved desirable goals, and are supported to pursue goals such as taking part in the Special Olympics. Some have taken part in national and international events, and others have travelled internationally to pursue their interests, and all are encouraged to developed particular skills of interest to them. All the individuals are able to take a holiday every year. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 11 Individuals are able to develop work skills in the different settings within the village, and some have paid employment. All the people at the home can see friends and family as they wish, and can choose to develop intimate relationships if they want to. Jewish people are helped to develop their appreciation of their faith through practice of observing dietary laws, weekly Sabbath and major festivals, and have the village cultural adviser to help if necessary. Individuals of other faiths are helped, through their keyworkers, to practice their own religion. The people at the home have collectively decided to eat lunch at the village canteen on several days during the week. This helps them to make the best use of their daytime opportunities in the village, including meeting up with peers and staff members in a social setting. On the day of the inspection visit all the individuals at the home spent lunchtime together, eating in a busy social atmosphere where they were able to choose what to eat and where to sit. The time was used to discuss the morning’s activity, reflect on issues and reminisce on past activities. The evening mealtimes take place in individual’s flats, and individuals are supported to choose and prepare nutritious food. All the individuals eat together one evening in the week, to observe the Jewish custom. Two individuals explained how these arrangements were very suitable for their needs. The home’s daily routines promote independence and individual’s choice, and staff members show respect for the individuals by respecting choice, attending to requests and understanding individuals’ needs. All the relatives who responded to the Commission’s questionnaire said that the home supported their relatives to live the life they chose. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. The people living at the home can rely on the skilled staff members to meet their healthcare needs, in ways that they themselves decide. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people at the home are supported to have access to healthcare services as they need, and all are registered with a local general practitioner. People needing specialist health care are supported to keep appointments outside the village as necessary, and NHS professionals and private practitioners are facilitated to come to the village. Records show that individuals are able to direct how their care should be delivered, and the individuals at the home are generally able to manage the majority of their personal care needs, with some support. Staff at the home know the individuals very well, and are able to anticipate and meet the physical and emotional needs of the individuals. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 13 No one living at the home manages their own medication, and the home has a medication policy and procedures to make sure that medication is well managed. Staff who administer medication have appropriate training, and the manager is able to discuss issues with the supplying pharmacy. Medication is well managed due to the good quality control system used, and is kept securely. All the relatives who responded to the Commission’s questionnaire said that the home ‘always’ gave their relative the care they expected and agreed. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Robust procedures at the home serve to protect the individuals, and enable their views to be heard. However, it is clear that not all appropriate checks are carried out during the recruitment of new staff, or during the transfer within the village of existing staff members from one home to another. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure and each individual has a copy that they are able to understand. The procedure is currently being reviewed, and the expectation is that the review, among other improvements, will make it clearer that individuals can approach the Commission at any time if they have concerns. The Commission has not received any information about complaints since the last inspection visit. Individuals are able to discuss matters that are important to them in their own way, and staff members understand that they need to make time to listen to them. Records of complaints are kept, and show that issues are responded to appropriately. One individual said that he trusts the staff members and is able to discuss anything with them. All the relatives who replied to the Commission’s comment cards said the service ‘always’ responded well to any concerns raised with them. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 15 The home has an adult protection policy developed to take note of the local multi-agency guidelines on safeguarding vulnerable adults, and training is provided for staff members. The good management of a recent adult protection incident has empowered the individual concerned in asserting his rights, and has confirmed the staff team in the strength of the home’s procedures. However, it is not clear that all appropriate checks are carried out during the recruitment of new staff, or during the transfer within the village of existing staff members from one home to another. The manager is vigilant about safeguarding issues within the home. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The flats are safe, comfortable and homely, and provide a good environment for the individuals living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is divided into three self-contained flats, providing two bedrooms, living room/dining room, bathroom/toilet and kitchen for each flat. Individuals are able to personalise their areas as they wish, and they contribute to the management of their areas on a daily basis. One individual who is hard of hearing has specialist equipment installed in his flat so that he will know when the doorbell is ringing. Each flat has a washing and drying machine to manage laundry, and the environment is comfortable and homely. The garden provides good outdoor space, and the wider grounds are also available to individuals living at Ahava. Some areas of the flats need redecoration and some carpeted areas need replacing or specialist cleaning. The entrance hall needs to be better cleaned on a regular basis. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. Trained and competent staff members are available to support the people at the home, but the recruitment process needs to be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff members understand their responsibilities in the home and the keyworker system defines this well. The risk assessments for individuals show how many staff members are needed at different times of the day, and the staff rota shows that enough staff members are available to meet the needs of the individuals. There is a pool of staff members available to cover staff absences, and a new deputy manager has recently been appointed. The home’s induction procedures meet the Skills for Care standards and are also tailored to the needs of the individuals. Other training is provided on health and safety issues, and on lifestyle and care topics around the needs of the people living in the home. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 18 The provider has recently recruited staff from the Philippines, and used an agency to carry out part of the recruitment procedure. Both the references that were supplied regarding a recently recruited individual from the Philippines were of a ‘To Whom it May Concern’ type, it was not clear that the organization had requested the references, and there was no evidence to show that the agency had verified the authenticity of the references. The provider confirmed that the agency does verify references, but evidence is needed from the agency to confirm this. It is a requirement that the provider requests written confirmation from the overseas agency that it is their practice that they request references from referees, and that they do not accept ‘To Whom It May Concern’ references, as seen on the day of the inspection visit. A new staff member, who is presently working on secondment at the home from another home within the village, has only one reference. Two references are required, so another references must be sought regarding the individual. No Criminal Records Bureau (CRB) check has recently been carried out for the individual who has been working for the provider since 1997. The provider explained that it is not the practice of the organisation to carry out new checks when existing staff members move between services, but this practice can put individuals at risk. When existing staff members move to another service registered with the Commission, new checks must be carried out as a safeguarding measure. New CRB checks including a check against the Protection of Vulnerable Adults List must be carried out for the individual discussed above, and for all other staff members moving from one Commission registered service to another. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The registered manager makes sure that the home is managed in the best interests of the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager gained the NVQ Level 4 some years ago, and is skilled and creative in making sure that the people at the home have access to a wide range of choices. She actively encourages the individuals at the home to discuss their ambitions, to strive for perfection and to achieve their potential. She has relied on the staff members responsible for recruitment to implement appropriate procedures, but this has not been consistent for all staff working at Ahava. The quality assurance system at the home has several strands, including residents’ meetings, staff meetings, monthly reports on the care of individuals, and unannounced monthly quality visits from a senior manager. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 20 The Norwood Ravenswood organisation is planning to include individuals living at the home in recruitment panels, and is providing specialist training for one of the people living at Ahava. Individuals at Ahava also contribute to the residents’ committee for the village, so that they can have their say on issues within the village. As there is no formal process for gaining feedback from relatives and other stakeholders, it is recommended that an annual quality assurance survey be carried out to gain their views, and that the results of the survey be published. The Norwood Ravenswood organisation has a health and safety policy statement and provides health and safety training for staff members. The village has a health and safety department, and a named individual has responsibility for the fire safety procedures at the home. Safety checks, including fire systems and water temperatures, are carried out according to an appropriate schedule. Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 X 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 2 X X 3 X Ahava DS0000011409.V330808.R01.S.doc Version 5.2 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 YA34 Regulation 19 Schedule 2 19 Schedule 2 Requirement Another reference must be sought regarding the individual discussed during the inspection visit. A new CRB check, including a check against the Protection of Vulnerable Adults List, must be carried out for the individual discussed during the inspection visit. New CRB checks must be carried out on all other staff members moving from one registered service to another within the village. 3 YA34 19 (1c) The provider must request written confirmation from the overseas agency that they request references from referees, and that they do not accept ‘To Whom It May Concern’ references. 30/06/07 Timescale for action 30/05/07 2 YA34 30/06/07 Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 23 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 YA30 Good Practice Recommendations The carpets in some areas of the flats should be replaced or be cleaned by specialists. The entrance hall needs to be better cleaned on a regular basis. An annual quality assurance survey of the service should be carried out to gain the views of people living at the home, their representatives and other stakeholders, and the results of the survey should be published. 2 YA39 Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 © 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 Ahava DS0000011409.V330808.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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