Inspection on 21/06/06 for Ashburnham Road, 95

This inspection was carried out on 21st June 2006.

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

Ashburnham Road, 95 08/09/08

Ashburnham Road, 95 25/05/07

Ashburnham Road, 95 31/10/05

Ashburnham Road, 95 13/04/05

Ashburnham Road, 95 13/01/05

Ashburnham Road, 95 04/08/04

Ashburnham Road, 95 17/02/04

Ashburnham Road, 95 05/08/03

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 Ashburnham Road, 95 Luton LU1 1JW Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 21st June 2006 1:00 Ashburnham Road, 95 DS0000014989.V297599.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 Ashburnham Road, 95 DS0000014989.V297599.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. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashburnham Road, 95 Address Luton LU1 1JW 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) 01582 481589 01582 481589 Advance Support Ltd Louise Cawley Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Complete Registered Manager’s Award in 6 months of becoming Registered Manager The role undertaken by the manager must not include working on the rotas on a day-to-day basis except in emergencies. 18th April 2006 Date of last inspection Brief Description of the Service: Advance Housing and Supported Living, a voluntary organisation, provides homes in the community for people with learning disabilities and mental health needs and owns 95 Ashburnham Road residential home, a three-storey building. The home is situated in Luton and provided care for four adults in the category of mental disorder. All the bedrooms are single and service users are encouraged to personalise their bedrooms. Service users bedrooms, a pay phone, bathroom and toilet are located on the second floor. The top floor is used for the staff sleeping-in room and is used by the service manager for an office. A call bell system is connected from the ground floor to the sleeping-in room, which the service user could use when required in emergency situations. The ground floor has a lounge/diner, toilet and a kitchen. The office is accessed via the kitchen and next to the utility room. Both the staff and service users use the pleasant garden, which is situated at the back of the home. The home is within walking distance of the park, shops, pub and a bus stop. The Town centre of Luton is three miles from the home. The minimum fee charged per service user was £540/- per week and the maximum was £ 580/- per week. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced key inspection carried out on 21/06/06 over 5 hours by pursotamraj hirekar. The method of inspection included review of outstanding requirements and recommendations, study of care plans, risk assessments, discussion with the service users’, staffs on duty, manager, partial tour of the premises, observations and the findings from the random inspection carried out by pursotamraj hirekar on 18/04/06. The manager coordinated the entire inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must consult all service users’ individually and collectively and develop individual specific activities that stimulate and engage service users’ to achieve assessed needs and aspirations. The home must ensure all the equipment provided at the home was maintained in good order and reasonably decorated. The home must ensure that each staff member had an individual training and development assessment and profile. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 6 The home should ensure consistency and continuity of support for services through providing care as specified in the individual care plan, monitored, and recorded, and regularly reviewed. 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. Ashburnham Road, 95 DS0000014989.V297599.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 Ashburnham Road, 95 DS0000014989.V297599.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had updated statement of purpose and service user guide that enabled potential service users to make informed decisions. EVIDENCE: The home had reviewed and updated the statement of purpose in May 2006, which was comprehensive and includes key information of services offered, staff details, organisational structure, category of service users, admission criteria and details of premises. The statement of purpose would enable the potential service users to make an informed choice. Alongside the service users’ guide was reviewed and updated with details regarding qualification and experiences of staffs, description of accommodation, support services and facilities, terms and conditions in respect of accommodation and a copy of latest inspection report. The home had a new admission of 1- service user on 11/01/06. The service user’s need assessment was concluded on the 12/05/06 and review was planned for the 16/11/06. The manager, senior carer, CPN and the service user participated in the need assessment and care plan preparation. Ashburnham Road, 95 DS0000014989.V297599.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had developed detailed care plans of service users. However, the identified action plans needed timely implementation without delays. EVIDENCE: Careplans of two service users were updated in February 2006 in a revised format which had informtion on self medication, social life, maintain life skills, medical appointments and longterm goals. The risk assessments of two service users have also been reviewed. Two more service users care plans and risk assessments have to be reviewed. The manager suggested time extension during the random inspection carried out in April 2006. All 4 service users care plans have now been reviewed and updated. New service user’s care plan was prepared on 12/05/06 and was schedule for review on 16/11/06. The manager, link worker and the service users’ signed the plan. The care plan had detailed information regarding mental health condition and medication plan. The needs assessment and care plan had detailed information on health care, daily activities, hobbies, interests, relationships, life skills, cooking, shopping, budgeting, cleaning and washing, Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 10 religious and cultural needs, nutrition needs, work and leisure, personal care, safety, financial, communication, triggers relapse indicators, medical reports were up to date and the latest medical report was dated 13/06/06. Service user had visited psychiatrist on 07/06/06 and visited nurse for 13/06/06 for BP and diabetes. Service user – 2’s is now 74 years and had recent appointment with the GP was on 10/02/06 for hormone injection, which was to be given every 6 months. Appointment with chiropodist was on 13/02/06 and blood test on 15/02/06. The service user was referred to lime trees by the psychiatrist on 06/04/06 and the home was awaiting lime trees to get back with a response. The home continued chasing the lime trees for meeting the mental health needs of the service user. Service user – 3’s recent appointment with chiropodist was on 07/06/06 and with GP on 08/02/06. The home was making efforts for a transfer of the psychiatrist, which was expected to take place after the conclusion of first six months care plan review. Service user – 4’s had latest appointment with GP on 22/01/06 and the psychiatrist’s appointment was scheduled for 07/08/06. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home need to further consult individually, all service users’ and develop activites that meet the individual service users’ needs and aspirations to achieve quality of life goals. EVIDENCE: The home had made plans to engage service users’ in meaningful activities that stimulate independent living and achieving quality of life goals. However, the service users’ in their comment cards and during this inspection have suggested that the daily activities need to be redesigned to consider individual service users’ needs and aspirations. The staff members’ have also suggested the same as well during this inspection. Service user – 1 is 64years and loves the food. During Monday, Tuesday and Friday goes to day centre, Wednesday does his personal laundry, and cleans his room and watch TV. Thursday goes shopping with the staff participates in household chores, over week ends helps in the kitchen, goes for local walks, reads news paper, visit town with staff member. Service user’s has a brother who lives in Israel and there was no contact between them, the step mom lives Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 12 in a home at Hemel Hampstead, Service user sends her birthday and Easter cards. Service user – 2 is 59 years old. During Monday, Tuesday and Friday goes to a day centre (work placement), is a very independent person and does his laundry on any day of his choice, goes out to meet his girl friend in Luton twice a week. Participates in cooking twice a week and does few tasks around the home. Service user – 3 is 74 years old. Attends day centre on Monday and Tuesday, rest of the week is at the home and goes out to town, has a sister who lives in Dunstable and visits her quite often and is a very private person. Does his own laundry, cleans his room, goes out to the pub one’s a month and sometime more. Service user – 4 is 64years old, he cannot be let alone outside the home, he goes out with the staff for shopping and he likes to go the church which he does once or twice a month and likes to visit cemetery and has not been yet. He has a brother who lives in Slipend and visits him once a month for the afternoon. The home had planned to organise a week’s holiday to Blackpool for all the service users’ and the service users’ were looking forward to the same. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The identified mental health needs of the service users’ needed sustained interventions to achieve desired goals. EVIDENCE: The home had made efforts to provide health care services and the details of these were as follows; Service user –1 health needs assessment was carried out and the service user sees psychiatrist every 6 months accompanied by staff. There was no change in medication since last 6 months. GP was seen as and when required but not as regular feature, since the service user is believed to be keeping good health. The staffs administer his medication as per the advise of the psychiatrist and GP. Service users’ family had not replied to his letters, the staff members’ sit with the service user and give psychological support. Service user – 2’s health assessment was carried out and sees the psychiatrists once in every 6 months. There was no change to his medication. The service user was on diabetic controlled diet. Service user has a mild cataract in one eye, which can be corrected with surgery. However, the service user does not want surgery, the GP say it’s ok. Service user – 3’s health assessment was carried out and has appointments with the psychiatrist once in every 6 months. Service user – 4’s health assessment was carried out and visit psychiatrist once in every 6 months. The service user had stomach ulcer and was on medication for his mental health needs as well. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 14 Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements with regard the complaints policy and procedures. EVIDENCE: The home had a comprehensive complaints policy and procedures. There were no complaints recorded since the previous inspection. Ashburnham Road, 95 DS0000014989.V297599.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home had maintained comfortable enevironment for the service users’. However, specifically needed to attend on the repairs and replacements of the furnitures and fixtures, to maximise the comfort level of the service users’. EVIDENCE: All the service users’, staffs and visitors smoke in the rear garden or in the utility room. The home is free from offensive odours. The home had made efforts to make the stay of the service users’ comfortable and free from environmental hazards. Once a month fire drills were carried out and the latest was on 08/06/06. The home had contracted with a company to conduct every 6 months electrical emergency lighting, lighting, fire alarm testing. The recent engineers visit for testing was recorded as 28/04/06. The home had weekly testing for emergency lighting, fire drill monthly and fire exits every day. The water temperature checks were done weekly, fridge and freezer done daily. The home had a maintenance log, which was used to get the repair work fixed by using the company hotline number. Fridge in the kitchen is broken and Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 17 need replacement/repair of the door. Bath on the first floor enamel was wearing off and need replacement to avoid any incidents of fall. Sink on the first floor toilet water was dripping and left green stains and need replacement. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 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 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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home now had a good skill mix of staff complemented with team work and, the home need to sustain the morale of the staffs in the best interest of the service users’. EVIDENCE: The home had a robust recruitment policy and practice. The staffs on duty were having good working relations with the service users’ and were making efforts to work as a good team. The discussions with the staff on duty is as follows: Staff – 1 has NVQ2 and plan to start NVQ3 in September 06, was working with the home since 2004 as a support worker and has been promoted to the position of team leader since 06/06. Key trainings received include administration of medication, fire safety, health and safety, pova, dementia care, personal safety, infection control and risk assessments. Staff – 2, was working as a support worker and the recent supervision was held on 30/05/06. Staff – 3 joined the home on 05/03/06 as a support worker, had CRB check and references. Staff supervision was held 27/04/06. Participated in various training programmes that include introduction to mental health, first aid, induction to advance, manual handling, effective communication, pova, medication and personal safety in work place. Staff – 4 was working as a support worker since 09/02, has NVQ2 and plan to start working on NVQ3. The key trainings received include administration of Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 19 medication, team working, health and safety in work place, food hygiene, pova, first aid, manual handling, report writing, effective communication, best practices in mental health, mental health legislation and person centred planning. Staff supervision was held on 31/01/06 and the latest one was in April 2006 and need to be on the staff record. Staff members’ in general have said that they now have good staff team, help service users become independent which was difficult because of the age group of service users’. Care plans had detailed goals that are practicable and achievable with short, medium and long-term goals. Also, suggested that The service users’ need to be taken out more frequently, have more activities that suit individual service users’ needs and aspirations, especially out door activities and ensure regular holidays of service users’ choice. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 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 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, 39 and 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The manager had made several attempts to meet the outstanding requirements and in improving the service delivery. However, there were areas that needed further improvements and sustained as well, to meet the assessed needs of the service users’. EVIDENCE: Quality assurance questionnaire was administered by the staff to the service users’ and staffs have also filled in seperate questionnaire developed for them. Service users survey, staff survey, stakeholder survey was carried out and a development plan was prepared for the year 2006 – 2007. The development plan /action plan indicated steps that were planned to be implemented include: to improve service users guide – this was achieved now, revise statement of purpose – this was achieved now, stakeholder survey – completed, staff training – to complete by end July 2006, Cosh needs to be updated by end of July 2006, property risk assessments to be updated by end of July 2006. The senior management has agreed for the manager to do NVQ4 and RMA in PACT education, Redding. The home now has a computer with LAN facilities. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 21 The manager was doing registered manager’ award training and plan to complete by 09/06. Staffs’ supervision was regularised and the staff members’ now work as a team. The manager had taken effective measures with the help of the staff team to meet the outstanding requirements. The good work need to be sustained and further improved. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 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 YA12 Regulation 16 (2)(m)(n) Requirement The home must consult all service users’ individually and collectively and develop individual specific activities that stimulate and engage service users’ to achieve assessed needs and aspirations. The home must ensure all the equipment provided at the home was maintained in good order and reasonably decorated. The home must ensure that each staff member had an individual training and development assessment and profile. Timescale for action 31/07/06 2. YA24 23 (c) (d) 31/07/06 3. YA35 18 (1) (c) 31/07/06 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 YA18 Good Practice Recommendations The home should ensure consistency and continuity of support for services through providing care as specified in the individual care plan, monitored, and recorded, and regularly reviewed. Ashburnham Road, 95 DS0000014989.V297599.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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. 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