Inspection on 23/08/06 for Ashbury

This inspection was carried out on 23rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ashbury 13/02/06

Ashbury 29/09/05

Ashbury 21/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Ashbury Ashbury Six Acres Close Roman Road Taunton Somerset TA1 2BD Lead Inspector Stephen Humphreys Key Unannounced Inspection 23rd August 2006 09:30 Ashbury DS0000035366.V303927.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 Ashbury DS0000035366.V303927.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. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbury Address 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) Ashbury Six Acres Close Roman Road Taunton Somerset TA1 2BD 01823 423126 Somerset County Council (LD Services) Mrs Heather Davies Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users who have a concurrent physical disability may be admitted to the home. 13th February 2006 Date of last inspection Brief Description of the Service: Ashbury is a single storey building situated close to Taunton town centre. There is a large lounge, dining room, two assisted bathrooms and two shower rooms at the home. Building work has recently taken place to increase the size of four service user bedrooms. The home is set in pleasant gardens that are accessible to service users. Ashbury is registered with the Commission for Social Care Inspection to provide care for up to nine people with learning disabilities, including two people who also have physical disabilities. The home is run by Somerset Social Services. The Registered Manager is Mrs Heather Davies and the Responsible Individual is Mr David Dick. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first inspection using the Commission for Social Care Inspection Inspecting for Better Lives methodology. The inspection was unannounced and carried out by one inspector over one day. On the day of the inspection there were nine service users residing at the home. The format of the inspection included observation of service delivery and speaking with service users, staff and the Registered Manager. Care records were examined and a tour of the premises was made. Part of the pre-inspection work included the analysis of comment cards sent to relatives and visiting professionals. Two responses were received from relatives and three from visiting health professionals. All respondents made comments on the high standard of care delivery to service users in the home. What the service does well: What has improved since the last inspection? The physical environment has been improved through the development of a wheelchair path and nature trail around the garden. Extra seating has been installed. The medication system has been reorganised to include a new cabinet and Boots have carried out Monitored dose system training for care staff. The registered manager said the quality of personal care has improved to service users who are aging. The quality assurance system has improved. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 6 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. Ashbury DS0000035366.V303927.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 Ashbury DS0000035366.V303927.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): 1,2,3,5 The quality in this outcome group is good. Service users and their families are provided with appropriate information regarding the home. Residents are provided with a written contract stating the terms and conditions of the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at Ashbury. Service users have lived at the home for many years. An assessment of need would be completed prior to any new service user being admitted to the home. Service users benefit from the skills and experience of the multidisciplinary team to assess their personal and social care needs. A contract is provided for each service user setting out the terms and conditions of the home. Ashbury DS0000035366.V303927.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): 6,7,9 The quality in this outcome group is good. A detailed care plan has been developed for each service user. Service users are supported in exercising choice through use of appropriate communication styles. EVIDENCE: Care plans have been developed and are maintained for each service user. The care plan format follows the standard model used by Somerset Social Services. Four care plans were examined in detail. Care plans provided information regarding service users needs, daily routines and preferences. Risk assessments had been completed where required. Care plans had been regularly reviewed and updated appropriately. There is written evidence to show there is a multi agency input into the identification of care needs. The philosophy of care in the home is to enable service users in maintaining their independence. Special equipment is provided to ensure the individual service user is protected from harm due to their health condition. Service users Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 10 are enabled to exercise choice regarding their daily routines through the use of total communication symbols. A key worker group, who work to ensure that the care provided meets individual needs, supports each service user. One service user has an advocate. A board in the hallway displays which members of staff will be on duty. Comment from one relative ‘the staff are really good at their job, we have no worries about the welfare of the service users’. A comment from a health care professional received ‘ Ashbury is a home that always puts the needs of the service users first’. The home will keep money securely for those service users who wish them to. Records are maintained of all transactions involving service user finances. The registered manager follows the financial management guidelines. Risk assessments are done on all residents regarding their abilities to handle money. Receipts and records were checked. The records are audited on a weekly basis by local auditor and annually by the auditor from County Hall. Bank and building society statements are filed individually. Ashbury DS0000035366.V303927.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): 12,13,14, 15,16,17 The quality in this outcome group is good. Service users can be assured the home is run to maintain their independence. EVIDENCE: Service users participate in a range of activities and are supported in accessing the local community based social entertainments and facilities. Service users access and attend the focus club, coffee mornings and trips out to various venues. Service users meet together with carers and using total communication symbols and pictures are enabled to collectively choose the outings and social events they prefer based on their individual wishes and likes. Service users are able to participate in a wide range of activities. At the time of inspection service users were enjoying watching videos and listening to music within the home and three service users were on an outing to the coast. One service user was taken out for a walk and cup of coffee locally. The activities occur seven days per week. One warm summer evenings the service users enjoy a bar-b-Q in the garden. Two service users attend a communications group at Somerset College Arts and Technology on a Tuesday and one on a Thursday. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 12 There is a ‘My Day’ plan recorded for each service user displayed on notice boards in their bedrooms. Service users are provided with regular opportunities to access the local community currently enjoying aromatherapy, hydrotherapy and attending the Harmony club. Service users are provided with a holiday away from the home or quality days out dependent upon their individual needs. During the next few weeks all the service users are going to a log cabin in the Blackdown Hills. One service user expressed their excitement at attending the Calvert Trust. Quality days out are determined at team meetings. Members of staff accompany service users on holidays and days out. Staff support service users in maintaining contact with friends and family. Comments received from relatives included ‘We often meet staff and also call by telephone every few days, staff are always really good’. Dietary guidelines are provided for each service user. A cook is employed at the home on a part-time basis. The menu is chosen by the service users using photographs of meals and regularly reviewed to ensure that it continues to meet service user’s dietary preferences and needs. There is a spacious dining room at the home. A notice board in the dining room displays the meals planned for that day. The main meal of the day is served in the evening with a light lunch. Ashbury DS0000035366.V303927.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): 18,19,20 The quality in this outcome group is good. Service users can be assured their individual personal care needs are met. EVIDENCE: Service users are provided with assistance to undertake personal care tasks. Personal care is provided in the privacy of the person’s room by experienced and skilled staff. The multi-disciplinary community team carry out health care monitoring of the service user. Evidence of health care professionals visits is recorded in the individuals care plan. Staff support service users in accessing health care services such as the dentist and ensure specialist advice is sought as required. Comments received from the General Practitioner include, ‘Ashbury maintains a very high standard of personal and appropriate care for service users’. Pressure-relieving equipment had been provided for one service user. Care plans included details of epilepsy and behavioural guidelines. Risk assessments had been completed in relation to the use of bed rails and other areas that may be a risk to the person’s safety. All care staff have received monitored dose system training from a Boots Pharmacist. All medications are stored securely. The receipt, storage, Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 14 administration and disposal of all medicines was checked and found to be satisfactory. Several medicines at random were checked and counted. The external creams were dated. Ashbury DS0000035366.V303927.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): 22,23 The quality in this outcome group is good. Service users can be assured that they are protected by robust procedures. EVIDENCE: The complaints procedure and appropriate policies relating to the Protection of Vulnerable Adults are developed by Somerset Social Services and used in all their care homes. The home has a complaints procedure displayed, which includes the photographs of people that may be contacted along with the Somerset Social Services Department video providing details of how to make a complaint. A copy of the Somerset Social Services document entitled ‘Our Promise to You’ and details of the Advocacy Service are displayed in the hallway. The Registered Manager has also ensured that the family of each service user has received a copy of the complaints procedure. Ashbury DS0000035366.V303927.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): 24,30 The quality outcome in this group is good. Service users can be assured of warm and well maintained environment that is safe and adapted to meet their physical needs. EVIDENCE: Ashbury is a domestic dwelling, warm, homely and well decorated throughout. During the inspection a tour of the home and gardens was made. The garden areas include a wheelchair path and nature trail. Appropriate soft coverings have been installed under the swing and bark along the path. The summerhouse can be accessed safely. The main door is opened by a keypad for security. The décor of the home is pleasant. The fixtures and fittings around the home including service users bedrooms are all in good condition. The furniture and furnishings were all in good condition and suitable to the service user group. The service users bedrooms were individually decorated to their taste. The window frame in two rooms is showing excessive wear and is in need of replacement. The seal around the wash hand basin in another room needs to be replaced. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 17 The bathrooms and toilets were well maintained. There was an over-head hoist in each of the bathrooms along with an arjo bath. Ashbury DS0000035366.V303927.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): 32,33,34,35,36 The quality in this outcome group is good. Service users can be assured that the staff are experienced and skilled in caring for persons with a learning and physical disability. EVIDENCE: Staffing levels are appropriate to meet service users’ needs. Duty rotas were checked to identify the staff on duty at the time of this visit. There are generally four staff on duty during the day and one waking, and one sleepingin member of staff at night. A part-time cook and domestic assistant are also employed. The registered manager said that recently agency staff have been used to cover staff absences. Two new members of staff are being recruited to increase the staff group. Newly appointed staff receive a thorough induction program and encouraged to go on to the NVQ training. Staff are provided with regular updates in mandatory training and receive further training in relation to individual service users’ needs. The file of a recently recruited staff member was reviewed and found to contain the information required under Schedule 2 of the Care Home Regulations 2001. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 19 The inspector was able to have detailed talks with three members of staff during the day. Evidence of teamwork and good morale was seen. Staff said they enjoyed working in the home. Staff confirmed that regular supervision is had with the registered manager and that the management is open and clear. Each staff member has a personal development plan and the organisation provides and encourages staff to undertake appropriate training to improve their skills and knowledge. Ashbury DS0000035366.V303927.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, 38, 39, 40,41,42,43 The quality in this outcome group is excellent. Service users can be assured that a competent manager who provides effective leadership to the staff team runs the home to their best interests. The organisation provides robust policies and procedures that are person focused. EVIDENCE: The Registered Manager is Heather Davies. She is an experienced manager and has obtained the NVQ level 4 qualification in Management and Care. Staff confirmed that they are very happy with the openness and team spirit developed by the registered manager. All staff spoken to said they were encouraged at supervision and staff meetings to make suggestions to move the home forward. None of the service users in the home are able to communicate verbally and therefore staff use total communication symbols and signs. All staff have received training in this communication system and service users respond with their own method of communications. The routines in the home are flexible to meet the service users needs. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 21 The home has appropriate policies and procedures in place to safeguard vulnerable service users. Staff confirmed that they had read the policies and procedures for the home. Evidence of policy and procedure reviews was recorded on the policy documents. Fire safety records were examined. Fire alarm tests are being done weekly along with the emergency lighting. Fire equipment is serviced and tested as required. Hazardous substances had been stored securely and were not accessible to service users. Accidents have been recorded as required using the homes reporting system. A random selection of the accident records was reviewed for four service users. No patterns could be detected. Maintenance records for equipment including over-head hoists and hot water temperatures were reviewed and satisfactory. Service users benefit from the organisations quality assurance system of regular audits. The financial records are audited weekly and the network manager carries out unannounced visits monthly to meet the regulation 26 requirement. Ashbury DS0000035366.V303927.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 3 2 4 3 3 4 X 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 4 3 3 4 4 4 Ashbury DS0000035366.V303927.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. 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 YA24 Good Practice Recommendations The two window frames identified as having excessive wear and tear should be considered for replacement. Ashbury DS0000035366.V303927.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Ashbury DS0000035366.V303927.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. 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. 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