CARE HOME ADULTS 18-65
Ashdale Byerley Road, Shildon, County Durham, DL4 1HN Lead Inspector
Patricia English Unannounced 31 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Ashdale Address Byerley Road, Shildon, County Durham, DL4 1HN 01388 777693 01388 777693 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) United Response Mr Graham Conway Spencer Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: PD LD (5 persons) Date of last inspection 1 December2005 Brief Description of the Service: Ashdale is a long established care home providing care for 5 younger adults with profound physical and learning disabilities. The home is a large bungalow with all accommodation and facilities on ground floor level. All bedrooms are single occupancy and are decorated and furnished to a high standard. Each bedroom has been fitted with aids and equipment to suit the specific needs of individual service users. There is good access throughout and it is situated in the community of Shildon close to all amenities and good public transport links. The home is surrounded by well kept easily accessible gardens. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately three hours and all five services users were present for part of the time. The manager and two staff members were in the home to give their views but there were no visitors during the inspection. On this occasion the inspector looked at standards under Lifestyle, Environment and Staffing. What the service does well: What has improved since the last inspection? What they could do better:
The current system where some staff records are kept centrally at the Head Office of United Response must be reviewed. The manager must make sure that all the records and documents relating to staff in respect of their Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 6 application for employment, references etc. are kept in the home and made available for inspection. 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. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed EVIDENCE: Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 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 standard(s) None of these standards were assessed EVIDENCE: Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 Service users have a healthy and nutritious diet and receive meals of their choice in a congenial setting EVIDENCE: Staff make all the meals and organise weekly menus which ensure that service users receive a balanced and nutritious diet and the process also takes into account each service user’s food preferences. Staff stated that service users have their lunch at their day placements during the week but each have a turn in choosing their particular choice of evening meal for the weekly menu. Weight charts are kept as part of their health monitoring process. Meals are taken in the dining room as a group and this was observed during the inspection to be a time for chatting about the day’s events and how they were going to spend the evening. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed EVIDENCE: Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed EVIDENCE: Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26 and 30 The home provides a comfortable, clean and safe environment in which to live. Service users’ bedrooms have been adapted to suit their individual requirements and promote their independence. EVIDENCE: The home is furnished and decorated in a comfortable, domestic style and was noted to be clean and tidy and well maintained. Evidence of inspections carried out by the Environmental Health Officer and Fire Safety Officer showed that the home was meeting the required standards; up to date maintenance certificates were in place e.g. gas, water systems, hoist equipment. The home is also subject to quarterly “service checks” which include health and safety checks, carried out by an officer from the Company (United Response). Each service user has a room of their own which has been specially adapted to suit their individual needs and this included specialist equipment such as their bed and an overhead hoist. Staff stated that they have all the equipment they need, and that it makes moving and transferring service users much easier and this benefits both them and service users. The two rooms viewed on this occasion had good quality furnishings and a colourful décor which staff
Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 14 said they helped service users to choose. They also work closely with relatives to help them make the right choices. Evidence of therapeutic equipment such as a fish tank, music and fibre optic lighting showed that their rooms had been personalised to suit their specific interests and personal requirements. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3l to 36 Staff are appropriately trained, supervised and supported in their role to ensure that they are competent out carry out the tasks required of them. Service users benefit from a dedicated and well managed staff team who work positively with them to improve their quality of life. The arrangements for recruiting staff must be reviewed to ensure that all the records and documents in respect of staff are kept in the home and made available for inspection EVIDENCE: There is always a minimum of two staff on duty and staff stated that the number varies according to how many service users are in the building and what activities are planned. The two staff on duty said that they all “worked well together as a team and supported each other where necessary”. This meant that they were able to support service users to have an active lifestyle as well as meet their personal care needs. Staffing arrangements also include a senior member of staff to be on duty on each shift which ensures that less experienced staff receive proper guidance. Regular monthly staff meetings are held which staff said are a good forum for discussion. Staff commented that they had “very good support” from the manager and that he “always listens” to them and “gives good advice and
Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 16 guidance”. One commented that “a lot of us have developed with the manager’s input” and that their monthly supervisions have proved very beneficial. Staff also receive annual appraisals which include a “personal development plan”. The manager stated that the supervision and appraisal programme is based on annual objectives and performance targets and it was noted that detailed records were being kept of this process. Staff also spoke highly of the home’s staff training and development programme which was very comprehensive and as well as mandatory training and National Vocational Training (NVQ) levels 2 and 3, the programme included courses focusing on the specific needs of residents particularly focusing on learning disabilities. One senior staff member has completed a specific communication training course and has ongoing support from the trainer to put her knowledge and skills into practice. It was stated that there have already had positive outcomes for some service users whose communication skills have developed through this training. It was confirmed that new staff are shadowed by senior staff for approximately two weeks or until they are deemed competent. It was noted that two of the most recently appointed staff have received induction training under the Learning Disability Award Framework accredited training to provide underpinning knowledge for progress towards achieving NVQs, and have been enrolled on mandatory training courses e.g. Moving and Handling, First Aid, Health and Safety etc. It was evident that all staff employed had completed a satisfactory Criminal Records Bureau Check (CRB). However, on inspecting two of the recently appointed staff’s records, it was noted that not all the records required for inspection were in their files. The manager stated that some of the records were kept centrally at Head Office where they also did some of the employment checks. Only the application forms could be checked and there were some discrepancies in the information provided under the employment histories that required attention. Suitable references could not be checked out due to the lack of evidence. Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed EVIDENCE: Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 4 4 x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 4 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Ashdale Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 19 Yes 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 34 Regulation 19 Schedule2 Requirement The arrangements for recruiting staff must be reviewed to ensure that all the records and documents in respect of staff are kept in the home and made available for inspection The employment history must provide the dates of employment and a satisfactory written explanation of any gaps in employment history Timescale for action 30 September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ashdale B54 S7450 Ashdale V232493 050705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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