Inspection on 12/12/08 for Ashdale

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Good service.

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

Ashdale 03/05/06

Ashdale 19/12/05

Ashdale 11/08/05

Ashdale 31/01/05

Ashdale 02/06/04

Ashdale 02/06/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashdale 1 Rakemakers Holybourne Alton Hampshire GU34 4ED     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mark Hemmings     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Ashdale 1 Rakemakers Holybourne Alton Hampshire GU34 4ED 01420549048 01420549269 ashdale@iliace.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Iliace Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Four people between the ages of 18 and 65 who have a learning disability can make their home in Ashdale (the Service). At present, the Servivce is full. All of the people have lived there for some years. They are settled and there are no plans for anyone to move on. The premises are an older detached house. Everyone has their own bedroom. Each of these has a wash hand basin. There is a bathroom on each floor. On the ground floor, there is also the lounge, the dining room, the kitchen and the laundry. The Service is in a residential street that is quite close to the centre of Holybourne. Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home There is a general store within walking distance. The Service has its own car. The Registered Provider is private company. It runs a number of other similar residential services in the area. People who might want to move in can find out things about the Service. There is a Service Users Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. If you want to find out more about Ashdale you can also have a chat with the Manager. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was a Key Inspection. We arrived at the Service at about 9 oclock and were there for about five and a half hours. It was a thorough look at how well things are going. We took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since the last inspection. We spoke with all of the people who live there. Also, we spoke with the Manager, with two of the support Care Homes for Adults (18-65 years) Page 6 of 30 workers and with the person who organises daily activities. We looked at some key records and documents and we had a look around the accommodation. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: No one has moved into Ashdale since we were last there. Therefore, we couldnt check out how the moving in process works in practice. However, we were able to speak with the Manager to get an idea of what will be done in the future when someone does say that they want Ashdale to be their home. The Manager says that he will speak with the person concerned to find out what support they want and what sort of life they want to follow. He will also speak with other people such as family members and care managers (social workers). This will be done so that he can check out points of detail that help him to be clear about what is needed. After this is done, the person will be invited to visit the Service. This is so that they can get a first hand feeling of what Ashdale is like. Also, this will be done so that they can meet the other people who Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: have already made the Service their home. The Manager recognises that moving into a new home is a big step to take. He emphasises that the Service wants to do everything possible to make the move a positive experience for everyone. We looked at some of the information that was collected to support someone who moved in some time ago. There is lots of useful stuff. For example, about their family and the contacts they have with them. There is also things about the support they need, their health and the sorts of social life they enjoy. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7, 9 and 10. People who use the Service experience good quality outcomes. There are quite detailed individual written plans of support. Unfortunately, these arent user friendly. Peoples medicines are handled safely. There is a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. There is a written individual plan of support for each person. These are important documents. This is because they are one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be done. The plans are a source of information for staff. This then helps them to provide support in the right way. We looked in some detail at two of these Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: plans. They have information about a number of relevant things. For example, theres information about how to help the people say what they want and about how to support them in managing parts of how they go about things. There is also information about how to help them with practical things such as getting dressed and using the bathroom. We spoke with two of the support workers about whats in these plans. They know it. They also know how to use the information in practice to give people the support they need. The plans are kept up to date so that they are accurate. This involves support workers making daily notes about how things are going. There are then twice monthly reviews. These are where the Manager checks out whats what and sees if any of the plans need to be altered. Once a year there is a larger review where people like care managers and family members are invited to have their say. As weve said the plans are quite detailed. This makes them long documents. We think that most if not all of the people who live in the Service might find them difficult to read and to find their way around. The Manager recognises this and he has introduced a new system where each person meets regularly with a support worker who is just for them. At these meetings, people can talk about how things are going for them, about what they might want to be changed and about how this can be reflected in their support plans. This is a really good idea. We hope that this process is extended. This is so that the plans of support can be written in a user friendly way to make them more interesting and engaging. All of the people who live in the Service are helped to manage their financial affairs by the Registered Provider. This involves it keeping a track of money coming in for them and then paying their bills. As part of this system, each person has their own bank account. On behalf of the Registered Provider, the Manager can sign for withdrawals. However, we think whenever possible the people who live in the Service should do all of their own banking, like everyone else does. Its a better idea for people to sign for their own withdrawals. This can be done with support from staff if this is necessary. Support workers hold small amounts of money for each person. They do this so that it doesnt get lost and so that they always have enough to buy the everyday things that they want. This is a sensible arrangement. Staff keep a record of the various transactions involved to make sure that everything is above board. We checked some bits of these records to make sure that the system is working okay. For example, we looked to see if there are receipts for things said to have been bought for people. There are. We also checked that the cash balance held for one person matches what the records say should be there. It does. At the moment, the Registered Provider says that support workers have to get a receipt for everything they help someone to buy for Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: themselves. We think that this is going a bit too far. Its a bit odd for example to have to ask for a receipt at a fish and chip shop or in the pub. It might make people feel awkward and different. We think that its enough for support workers to fill out the forms already in use and for the accounts to be checked regularly by the Manager. Sensible consideration is given to peoples personal safety. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, one of the activities that people like doing is trampolining. Staff have looked at this and they make sure that one of them is around to check that things are okay. Say for example, that someone isnt jumping too high or doesnt look like theyre going to fall off the thing. As before, the information isnt written in a user friendly style. We think that more can be done to make it interesting. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14, 15, 16 and 17. People can do occupational and social things that interest them. They are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: People are free to do things that interest them. Some of these things involve helping out a little bit and in their own way around the house. They help with tidying up and they go food shopping with support workers. The Registered Provider runs its own activities service. People from all of its local services go along on most weekdays. There they do things such as the trampolining we have already mentioned. They do other things too such as swimming, gardening, bike riding and keep fit. When we were Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: there one of the cooking groups that people normally go out to was being held in the Service. This was because the hall that they normally go to had been booked by someone else. There was a very lively atmosphere in the kitchen. Each person was helped to ice and to decorate their own Christmas cakes that they had made before. There was lots of flour and icing sugar all over the place. Everyone was was having a really good time. We checked out in a bit more detail who is doing what and when. Just to see that no one is getting overlooked. No one is. Everyones got a full week of both occupational and fun things to do. We asked one person about all of this. They say, I do lots of things. I like the trampoline and the bike. We go into the shops and I like buying things and doing things. I like home too. Ive done my cake today, Ill show you. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service whenever they want. We looked at the records about this. They show that support workers are on the phone to family members to tell them how things are going. Also, to sort things out such as who is comming to the Christmas party. People say that they have good quality meals and that they have enough to eat. Support workers do most of the main cooking, but some people do help with bits of it. There is a weekly menu. However, this is not too rigid. People can and do change it if they want something different. Over time, everyone has got to know what each other likes and dislikes. The menu pretty much reflects this. We looked at the record of meals served. People are having normal things such as omlettes, turkey escallops and spanish tortillas. There is a big bowl of fresh fruit in the kitchen. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are helped in ways that are right for them. A good sign is when people want to talk about things that interest them rather than wait to answer our questions. This happened all the time to us. People talked about going out Christmas shopping, buying presents and whats on the television. They take for granted that their home is how they like it and that support workers are their friends. The support workers are relaxed and informal in how they are. Things are orderly without being too much so. When things look like they might be getting a bit too much, they gently point people in a different direction. This isnt done in an obvious or bossy way. For example, when we were there one person thought they needed to use the bathroom. They were getting upset because they werent quite clear what to do Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: next. A support worker quietly spoke with them and helped them to go off to the bathroom. When they came back they were quite settled and moved on to doing something else. People are helped to wear neat and clean clothes so that they can look how they want. They are helped to sort out any post they get and they can use the phone when they want. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, a number of people have seen their doctors, some on more than one occasion. There have also been visits by other professionals such as district nurses. One person has a special medical need. We looked in detail about how they are being helped to deal with this. They have seen their doctor and they have had various tests done. Support workers have had training about what they need to do to help the person if they are not well. Also, they have organised how they go about it. People are also helped to take care of themselves in a positive way. For example, by eating a balanced diet or by watching their weight. At the moment, no ones doing their owm medication. Support workers are managing it for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. We looked at two sets of these records. They are correctly completed. We looked at two medicines in more detail. We wanted to see if the remaining stock matches what should be there. It does. All in all the system is running well. But we think that more can now be done to support some of the people to be more involved in things. For example, the form that staff use to record when a medicine is given is very complicated. Its got lots of small boxes to tick and there is a medical type account of what each box means. The Manager is going to look at what can be done to set up a easy to use form that at least some of the people might want to use for themselves. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 22 and 23. People are free to make a complaint if they want to. People are kept safe. Evidence: There is a written complaints procedure. This uses a lot of pictures and so it is likely to be easy for people to use. The Manager says that the Registered Provider has not received any complaints or even any grumbles since we were last in the Service. He says that if there are any in the future they will be sorted out as quickly as possible. This is so that anything that needs to be put right will be done. We asked people who live in the Service about this. No one spoke about it directly. Other than to say that they dont have anything concerning them at the moment. People say and show by their relaxed manner that they feel safe living in Ashdale. The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, if someone is being bullied or pushed around in some way. We spoke with two support workers about this. They know what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. Care Homes for Adults (18-65 years) Page 19 of 30 Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24 and 30. People live in a comfortable setting that promotes their independence. The kitchen is clean and well equipped. There is a separate laundry. Evidence: The accommodation is comfortable and homely. In general, its like anyones home is. Something a bit out of the ordinary is some of the signs that have been put up. For example, a no smoking sign on one of the front windows, a large health and safety poster in the kitchen and policy type document on the wall by the front door. These are very unsightly. Theyre the sorts of things youd expect to see in an office somewhere. People say their home is kept warm enough in winter. The radiators are fitted with guards. This has been done to reduce the risk of someone being burnt if they fall against one. The hot water is temperature controlled. This is to help reduce the risk of someone being scalded. We tested a few of the hot taps. The water isnt too hot. There is a problem at the moment in that the hot water supply to the first floor can be hit and miss. The Manager says that a plumber is looking into this. He expects the Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: problem to be sorted out quite soon. The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the Hampshire Fire and Rescue Service says that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. We could only look at an old copy of the assessment. A more up to date assessment has just been done but it hasnt been sent yet to the Manager. We understand that it doesnt say that anything new needs to be done. The Manager is going to double check that this is right. He is then going to send the assessment to the fire brigade people. This is so that they can check that the fire safety things in the Ashdale are still up to the national standard. This will be done by 1 May 2009. The people from the local Department of Environmental Health havent called to the Service for some years now. The Manager is going to get in touch with them to see if they would like to call again. This is a good idea because they know in detail about good food management things. In the meantime, we looked at the kitchen. Its neat, clean and looks like anyones kitchen. Theres a system to make sure that the refrigerators are cold enough to store foods safely. Sensible steps are taken to promote good hygiene. For example, staff know about the importance of washing hands. In particular, if theyve been doing other things like working in the laundry. The laundry has got a washing machine and a dryer. Staff say that this is enough to get through everyones washing without things building up. There are new regulations that have been introduced to ensure that used water doesnt leak back into the main pipe-work. The Manager is going to check with the local water supply company to make sure that the Service meets whats needed. This will be done by 1 May 2009. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 33, 34 and 35. There are support workers around to make sure that people get the help they need. Security checks are completed on staff. Support workers know what they are doing. Evidence: There are always two workers on duty from early in the morning until the evening time. There is a waking staff presence in the Service at night. We looked at the roster to see if the various shifts are being filled reliably. We found that they are. Its very important that all of the supprt workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, getting references and doing a police check. We looked at the personnel file of one support worker who has been appointed recently. The file is neat and organised. The required security checks have been completed. New support workers have introductory training before they begin supporting people. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: After their introduction to the Service, they start completing a more detailed training programme. This involves them filling out a workbook. When doing this, they have to read various guidelines. They also have to make sure that they understand things such as how to support people to take everyday risks in a sensible way. Or, what health care each person needs. Their progress through the workbook is checked by the Manager. This is so that he can be sure that they have the knowledge and skills they need by the time they finish it. We think that this is a very good idea. This is because its all about what support workers actually know in practice. Its this that makes a difference to the people theyre supporting. In addition to this, a new support worker completes a number of relevant training courses. For example, in things such as first aid, health and safety and food hygiene. These courses are then repeated every now and then. This is done to make sure that they keep up to date with what is seen to be good practice. We looked at the records of who has done what courses in the past three years. There are no obvious gaps. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to support people being helped in ways that are right for them. At the moment, there are seven support workers employed in the Service. The Assessment says that two of them already have the qaulification and three more are working towards it. When we spoke with support workers we asked them about points of detail to do with their work. We wanted to see what they know about a range of things likely to be relevant to working in Ashdale. They have a sound understanding of important things. Such as about how people prefer to express themselves and we saw them putting what they know into practice. They also know about how some people need special reassurance when they are anxious. Again, we saw them helping people to manage okay if they become distressed. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 and 42. The Service is reliably managed. People are asked what they think about how things are going, but this could be a bit more developed. Peoples health and safety is promoted. Evidence: The Manager is running Ashdale in addition to the service he is registered for. This is because the Registered Manager for Ashdale is currently on maternity leave. Although the Manager has the two services, he knows whats going on in Ashdale. He has one of the two formal qualifications that we expect and hes on with doing the second one. These qualifications are important. This is because they are intended to help managers ensure that people receive high quality residential care services. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there are staff meetings. We looked at the Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: records of the most recent meeting. A number of things that make a difference to peoples quality of life were discussed. For example, they discussed how to make sure that there arent too many last minute changes to the staff who are going to be around for a particular shift. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. For example, they know who needs the most support when they go out and they organise themselves accordingly. People are asked about how well they think things are going in their home. These include informal everyday discussions. There are also each persons one to one sessions with the key workers that we spoke about earlier. The Registered Provider sends each person a questionnaire each year. Members of their families and support workers also get one. We looked at the questionnaire sent to the people who live in the Service. It asks lots of questions about things such as their meals, their activities and the support they receive. Its not written in a user friendly style. This is a bit odd given that its supposed to be asking them what they think about things. Were not surprised to hear that support workers have to give people quite alot of help to fill them in. Once they are returned, the Registered Provider does a summary of what people have said. Again, we looked at what the people who live in Ashdale are saying. Most of it is very postive. For example, everyone is very satisfied with the variety of their food and with the medical attention they get. However, there are some less positive responses. Although most people are very satisfied with the help they get one person said they they are only quite satisfied with it. There is a similar response for the range of social activities people do. The most negative response was half of the people saying that they are not satisfied at all with the seating arrangements at meal times. Were not quite clear what happens to these summaries once they are prepared. They were done before the Manager took up his post. He is not sure, but he doesnt think that the people who live in the Service have been told about the results. The summary we saw is not written in a user friendly style. Its full of codes and percentages. Also, the Manager is not aware of anything having been done to find out what is behind the less positive comments so that improvements can be made. We think that the present arrangements need to be developed to sort these points out. We have asked the Manager to do this in time for us to be told about what has been done when the Registered Provider sends us its next Annual Quality Assurance Assessment. The Registered Provider has got its own compliance team. These are senior staff who call to the Service each month to double check that things are being run how the Registered Provider thinks they are. We looked at the records of two of their recent Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: visits. They are quite detailed and they show that all sorts of things are being looked at. For example, whether or not the individual plans of support are being kept up to date and what is being done to help people stay in good health. We looked in more detail at one of things they said needed to be done. This involves the need to get some more detailed guidelines for support workers to follow when giving one medicine in particular. The guidelines are now in place. Regular checks are done to make sure that the Services fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells and quarterly more detailed checks completed by a contractor. There are unannounced fire drills. There is a system for each member of staff to attend an annual fire lecture. This is very important. This is because the level of fire safety protection in the Service largely depends on staff doing the right thing at the right time. We looked at the records of who has done this training. There are two people who are overdue. The Manager is going to introduce a new system. This will make sure that at least once every six months checks are done to make sure that staff know how to use the Services fire safety procedure. The Manager is going to do this by 1 April 2009. The gas-fired appliances have been seen in the past year by an engineer who has said that they are safe to use. We understand that the electrical wiring in the Service has also been passed. However, theres no paperwork to confirm this. The Manager is now going to find this and he is going to check to make sure that everything is indeed in order. Hes going to tell us about this by 1 May 2009. We looked at the record of accidents and other untoward events that have occurred in the Service this year. There is nothing out of the ordinary in the sense that we need to make further enquiries. The handyman checks the place over each week to make sure that theres nothing broken that needs fixing. He keeps his own records so we couldnt see what sorts of things he looks at. However, support workers say that everthing is working okay at the moment. The building is also checked over by the compliance team we mentioned earlier. It hasnt found any particular hazards that might cause someone to have an accident. We kept our eyes open too and we didnt notice any hazards either. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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