Inspection on 19/04/05 for Ash Care Home

This inspection was carried out on 19th April 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

Ash Care Home 30/09/08

Ash Care Home 26/09/06

Ash Care Home 12/10/05

Ash Care Home 03/11/04

Ash Care Home 05/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Ash Care Home 41 Court Farm Road Mottingham London SE9 4JL Lead Inspector Sue Meaker Unannounced 19th April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Ash Care Home Address 41 Court Farm Road Mottingham London SE9 4JL 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) 020 8857 1183 020 8402 2416 Mr Ashok Kumar Aubeeluck Mrs Rajwantee Aubeeluck CRH 6 Category(ies) of LD 6 registration, with number of places Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 6 Adults/Elderly men with a learning disability (within the category mental handicap) Date of last inspection 3rd November 2004 Brief Description of the Service: Ash Care Home is a detached house situated in a quiet residential area of similar properties, overllooking playing fields. The home is within walking distance of local shops and public transport. The home provides care and accommodation for six people with a learning disability. The residential accommodation is on two floors accessed by steep stairs with a banister fitted to the wall, which makes it partly unsuitable for people with significant mobility difficulties. Central Heating is provided to all areas of the home and servcie users can control the temperatures in their own rooms. Each of the service users had their own bedroom fitted with a vanity unit supplied with hot and cold running water. There is a shared bathroom on the first floor and a toilet on both levels. Service users had full use of the kitchen, a comfortable lounge and a dining/conservatory area. Service users also had easy access to a telephone and each service user may have one in their own room at their own expense if they wish. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced statutory inspection of Ash Care Home undertaken on the 19th April 2005; the inspection began at 10.00 am and lasted six hours. The home caters for six people with learning disabilities; who have been resident in the home for a number of years; all the service users were placed and funded by the local authority. The owner and the registered manager were present for the inspection as were two of the service users. Time was spent in discussion with the owner and the manager, who are very much involved in the day to day running of the home, they also employ three part time members of staff to help them. The two service users who were at home, the other four being at local day centres. What the service does well: The management and the staff of the home encourage and support the service users to lead independent lives inside and outside the home. The home has a comfortable homely feel and is decorated, furnished and equipped to a high standard providing the service users with a safe and friendly environment in which to live. The service users spoken to confirmed that they were happy and that they felt involved in the day to day running of the home, they enjoyed the facilities and activities they pursued, particularly the recent holiday they all enjoyed. The service users have individual plans of care that are detailed and tailored to specific needs particularly relating to how much support and encouragement was needed by individual service users to maintain their independence. The home has good links with the local community and is able to access healthcare facilities for the service users including doctors, chiropodists, dentists and opticians. The home has a stable staff team, who are supported by the home manager, the home has a robust recruitment and selection process and all staff receive an in depth induction prior to commencing employment. The management of the home support and encourage the staff to update and improve their skills by accessing relevant training enabling the home to provide a consistent quality of care. The home involves the service users, their family and the staff in how the running of the home, everyone has input and are encouraged to make suggestions and to voice any concerns or problems they may have, it was evident from talking to the service users that they are listened to and that they Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 6 feel comfortable discussing issues with the owner and the manager of the home. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 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 Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 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) 1,2,3,4 and 5 The home provides the service user with comprehensive information relating to how their care and social needs can be met enabling them to make an informed decision about admission to the home. EVIDENCE: Currently there are six service users resident in the home, each of the service users has a personal file that includes the homes Statement of Purpose and Service User Guide. These documents clearly state the aims, objectives and philosophy of the home, its services and facilities and terms and conditions of admission to the home. It was evident from the personal files that a thorough assessment of care and social needs had been undertaken. Service users were referred to the home by social services who complete the initial assessment prior to admission; the service user and their family is involved in this process and an informed decision made as to the suitability of the home to meet their care and social needs. Any specialist needs were identified during the assessment process and detailed in the care plan. The home undertakes a coping skills assessment that covers all aspects of daily living and this forms part of the individual care plan for the service user. Service users confirmed that they had visited the home prior to admission in order to meet the other service users and the management and staff of the home. A review was conducted after the first three months enabling service users to decide if they wished to remain in the home. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 9 The service users personal files contained copies of their contract from social services, and the homes “Residents Contractor Statement of Terms and Conditions”; this contract was signed by the service user and the home manager; the contract contained details of the room to be occupied, the furniture and fittings provided and the facilities available within the home. It was evident, from the service users personal files that the assessment and admission process was managed with sensitivity and that the service users and their families were consulted at every stage. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 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 Care plans were personalised and individual to each service user promoting independence and choice respecting their dignity and privacy; enabling them to take risks and make decisions about how to achieve their personal goals. EVIDENCE: Six service user care plans were seen and it was evident that service users received the appropriate support from the staff to achieve their individual goals and aspirations. Service users confirmed that they were able to make decisions concerning the level of support they needed relating to personal care and any social activities they wished to pursue. Service users confirmed that they were involved in the day to day running of the home, particularly around any household matters and also when planning outings and holidays; regular meetings are held and all items discussed were documented, service users felt that they were listened to and any concerns they had were addressed by the home manager. Service users felt that they were encouraged to be as independent as possible and the coping skills assessment clearly identified their individual capabilities; the home manager had undertaken risk assessments around moving and handling and environmental issues so that any potential risk to the service use was minimised. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 11 It was evident that the staff of the home understood the reasons for confidentiality concerning the service users in the home, these issues were addressed during the induction process, and it was evident from the staff personnel files that this training is full documented, relating to the homes comprehensive policy and procedure on confidentiality and therefore complying with the Data Protection Act 1998. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 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) 12,13,14 and 15. Service users are supported and encouraged to participate in activities to enable them to live fulfilling lives outside as well as within the home. EVIDENCE: The home provides transport for the service users enabling them to attended various day centres in the local area; the home also arranges, in consultation with the service users, local trips and outings. Some of the service users are able to use public transport and had bus passes for this purpose; this gave them the independence to plan their own outings and also enabled them to visit friends and family on a regular basis. It was evident from speaking to the home manager and service users that visitors are welcome at the home at all reasonable times and that the service users were able to entertain them in the privacy of their rooms or in the homes communal areas. It was evident from speaking with the service users that they are an integral part of the local community and that they enjoy the amenities offered in the local area. The management and staff of the home support and encourage the service users in any activity they care to pursue, the home offers the use of a computer, one of the service users has his own computer in his room. Most of the service users Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 13 have their own television, and there is a large wide screen television offering Sky Sports for their communal use with a large collection of videos and DVD’s All the service users spent a holiday, over the Christmas and New Year, in Mauritius, it was obvious from the photographs and conversations with the service users, that they all had a wonderful time and really enjoyed the experience, and were already planning their next holiday. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 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, 19 and 20 The management and staff of the home have a good understanding of the service users needs relating to personal and healthcare support needed to promote their privacy, dignity, choice and independence. EVIDENCE: The service users resident in the home are for the most part able to address their own personal care needs; although it was evident form the care plans that they sometimes needed to the encouraged and prompted particularly around help with bathing and showering. The service users were encouraged and supported to undertake tasks for themselves with an appropriate level of input from the staff therefore maintaining their choices and enabling them to preserve their independence. The service users have access to all healthcare services including their own GP. dentist, optician and chiropodist; records of all these visits were kept on their personal file. Currently none of the service users are able to be responsible for their own medication; medication was administered by a trained member of staff. Training relating to the safe handling and administration of medication is given by the local pharmacist, staff receive a certificate on completion of the course. All the medication was kept securely in a locked cupboard and all medication given was recorded correctly. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 15 Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 16 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 The home has systems in place to protect service users enabling them to feel safe and secure in their home. EVIDENCE: The home has a comprehensive policy and procedure relating to complaints, which is easily accessible to service users, their family and friends; there has not been any recorded complaints since the last inspection. The home held monthly meetings with service users where issues are discussed and the service users confirmed that any concerns or suggestions they voice are listened to and acted upon; they felt involved in the way in which the home was run, as they were also invited to attend staff meetings; details of these meetings were recorded in documentation seen at the time of the inspection. The home had a copy of the local authority’s guidelines on Adult protection, supplemented by the homes’ own policies and procedures; all staff had attended training courses relating to “Abuse Awareness and The Protection of Vulnerable Adults”. Staff training records seen confirmed that this training had taken place and that the staff demonstrated an understanding of issues pertaining to the protection of vulnerable adults and that they were aware of how to instigate the homes’ “whistle-blowing” policy and procedure. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 17 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 and 30 The home enables service users to maintain their chosen lifestyle by providing accommodation and facilities tailored to their individual needs. EVIDENCE: The home provides the service users with a homely, comfortable and safe environment that is maintained to a high standard. The home offered good communal space for the service users, with the use of a large bright and well equipped kitchen with an adjoining dining room, where service users ate their meals together. The home had received the Clean Food Award from environmental health and the certificate was displayed in the kitchen. There were laundry facilities where service users were supported by staff to do their own washing. The two lounges were comfortable and well decorated and furnished, where the service users could socialise in the evening either watching television or playing various games. The service users also benefited from a large enclosed garden with a vegetable patch, tended by the service users, providing a limited supply of fresh vegetables and fruit. One of the service users was a keen gardener and had been very much involved in the planning of the garden, currently work is being done to get the garden ready for the summer. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 18 The service users rooms were well decorated and comfortably furnished, and reflected individual tastes and interests; the rooms were individualised with items of furniture, ornaments, pictures, photographs and books. Most of the service users had their own televisions and music systems, one service user had his own computer. The rooms all had wash hand basins and the service users had access to bathrooms and toilets near to their rooms and the communal areas. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 19 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) 31,32,33,34,35 and 36 The management and staff of the home are competent and have the skills necessary to meet the needs of the service users achieved by effective recruitment, training and supervision. EVIDENCE: The home has comprehensive policies and procedures relating to the selection and recruitment of staff. It was evident from the staff files seen that the home manager was fully conversant with the regulations governing the employment of staff in the home; all the correct procedures had been followed and the personnel files contained proof that the staff member had the skills and competency to be able to meet the assessed needs of this group of service users. All staff had a job description and person specification enabling the management of the home to determine the competence and skills of the prospective employee. Staff are made aware of the aims and values of the home as part of their induction training and are encouraged to develop an empathy with service users being aware of the goals to be achieved by the service user, encouraging and supporting where appropriate so as not to compromise the service users choices and therefore maintaining independence for the individual. It was demonstrated, at the inspection, that the service users felt comfortable when approaching staff and that they were treated with respect and sensitivity. Staff were involved in the care planning process and Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 20 discussed with the service users how their needs were met in regard to the amount of encouragement and support they wanted with personal and social care. It was evident from the personnel files that staff received training that was relevant to the needs of the service users and that they had the knowledge and skills to support service users with learning disabilities. Relevant training was accessed via the local college, the owner and the manager of the home were also able to give specific training around the special needs of the service users. The staff received regular updates relating to their moving and handling, food hygiene, first aid and health and safety training; certificates of this training were in the individual personnel files. The home manager held regular meetings with staff individually and sometimes in a group to discuss any concerns and issues they may have relating to their care of the service users; these meetings were also used to discuss any specialist training requirements. Staff also had an annual appraisal undertaken by the home manager to review their overall performance throughout the year and to discuss their personal development plan for the coming year. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39 and 42 The home benefits from efficient and effective management enabling the service users to feel safe and protected. EVIDENCE: The home has a stable staff team and is able to offer the service users a consistent high standard of care; the manager has successfully completed the Registered Managers Award. It was evident that the owner and the manager are very involved in the day to day running of the home and that the service users and staff feel comfortable in speaking to them about any concerns or problems. The service user group have been resident for a number of years and the atmosphere in the home reflected this situation. The home manager had developed a questionnaire that the service users and their families could complete; this gave the manager insight into how they perceived the quality of care they received, copies of this questionnaire were kept on the service users file, all the comments made were positive and demonstrated how much the service users valued the care they received from the staff and management of the home. Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 22 The safety of the service users was a high priority for the home manager, and was monitored on a regular basis, it was evident from records viewed that the home complies with health and safety legislation enabling the service users to feel safe in their own home. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x x 3 Standard No Score Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 23 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x 3 3 4 3 x x 31 32 33 34 35 36 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 24 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 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. 1. Refer to Standard Good Practice Recommendations Ash Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 25 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA14 5RH 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 Care Home G51s6885Ashcarev215114.19.4.2005stage4.doc Version 1.20 Page 26 - 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!