CARE HOME ADULTS 18-65
Ashdale House 14 Silverdale Road Eastbourne East Sussex BN20 7AU Lead Inspector
Mike Flint Key Unannounced Inspection 18th July 2006 09:50 Ashdale House DS0000021440.V303823.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 Ashdale House DS0000021440.V303823.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. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ashdale House Address 14 Silverdale Road Eastbourne East Sussex BN20 7AU 01323 728000 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) Alliance Home Care (Learning Disabilities) Limited Maureen Prescott Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is ten Service users in addition to having a learning disability may also exhibit forms of challenging behaviour Residents should be aged over eighteen and under sixty five on admission 31st January 2006 Date of last inspection Brief Description of the Service: Ashdale House is a large detached property situated a short walk from Eastbourne seafront and the towns shopping centre. Accommodation is on four floors, including a small self-contained flat and nine single bedrooms. There is a walled, rear garden for residents use. The home is registered to provide residential and social care for ten younger adults with a learning disability, who may also have challenging needs and autistic spectrum disorders. The registered providers are Alliance Home Care (Learning Disabilities) Limited, which owns other residential care homes in East Sussex, as well as in other parts of the Country. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, although the home was informed on the day before it was carried out, in order to confirm the manager’s presence. The requirements from the previous inspection, the information provided in the pre-inspection questionnaire completed by the manager, and the comments from the relatives of residents, staff and Community Team workers, were used to inform this ‘key’ inspection. Standards not assessed during this inspection were assessed during the previous two inspections, in August 2005 and January 2006. The aims of a key inspection are to assess the home’s performance in respect of a performance rating. Ashdale House had met, or was in the process of meeting, the small number of recommendations and requirements recorded in the previous inspection reports. This visit identified aspects of the service that demonstrate positive outcomes, as well as just two areas, where Standards are not being met. The inspection was carried out over five hours and included a review of record keeping, recruitment procedures, staff training and the management of the home. Duty staff were spoken with and the residents were observed at their various activities. There were no visitors during the inspection and the home’s managers and senior staff were helpful in discussions relating to the care provided. The current scale of weekly charges at the time of this inspection were from £864.00 to £3,272.99 What the service does well:
The needs of residents at Ashdale House are complex and often challenging. At the time of the inspection the atmosphere in the home was calm, comfortable and orderly; staff were observed responding attentively and with due consideration to residents’ needs. The residents appeared content with the support they were receiving and were seen responding positively to prompts and guidance from their support workers. The care provided at the home is of a high standard, evidenced by the progress being achieved in terms of each resident’s quality of life. Residents are encouraged to make choices about how they spend their time, some preferring to remain in the lounge, or sensory room, whilst others are taken for daily outings, including College attendance. A weekly programme is produced for each resident from a wide range of physical, recreational and educational activities that has been established; most of the residents spend part of each day off site, which is encouraged to stimulate the residents’ well
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 6 being. Again the home achieves a high standard regarding this aspect of the services provided. Some of the comments received included the following: ‘Really very pleased with the home’ ; ‘Staff are exemplary’ ; ‘(name) is so happy there’ ; ‘Staff will bring (name) over to see us, even if its just for a couple of hours’ ; ‘(name) always looks happy and healthy’ ; ‘appreciate the professionalism’ ; ‘very happy, can’t fault it’. Favourable comments were made about the service provided by Social Workers from two of the placing Authorities, who were spoken with. What has improved since the last inspection? What they could do better:
An examination of staff files showed that not all staff have a Contract of Employment with the organisation. The manager confirmed this to be the case, since the task to issue these had been passed to the home’s registered manager from the organisation’s Human Resources manager. In terms of staffing arrangements, the support workers carry out all the cooking, cleaning and laundry tasks, as part of their collective duties. Previous reports have recorded concerns about the varying quality of meals served. The menu plans produced include a range of bland and basic meals that may readily be prepared by support workers, who have no catering qualification, or suitable experience. Furthermore, the Inspector observed that a resident might often be assisting the delegated support worker in the activity of meal preparation. In respect of hygiene, it is required that any food preparation, engaged in as an activity for residents, is kept entirely separate and it is strongly recommended that a qualified cook be employed. A comment received form a social worker suggested that there may be a lack of engagement with her profoundly deaf client, who is resident at Ashdale House. In this case, additional to core care, the funding agreed includes 1:1 support for part of each day. The worker was concerned that her client’s weekly timetable showed long and frequent periods of ‘free time’. The home’s management should ensure that they are aware of such issues through maintaining regular contact with the various agencies, in order that appropriate action may be taken. Such contact may then contribute to the home’s quality assurance measures.
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 7 During a physical inspection it was noted that many of the hot water outlets, to which residents have access, are not fitted with temperature control valves; consequently, hot water at some of the checked outlets is being delivered at scalding temperature. On the day of the inspection, one of the two people carrier vehicles was unroadworthy; in questioning staff and the person responsible for vehicle maintenance, the Inspector was informed of the disruption to planned activities that vehicle breakdown often resulted in. The Inspector thanks the manager, the deputy manager, the staff and residents for their participation, co-operation and hospitality shown during the course of the inspection. Thanks also to those others, who have submitted their written comments, or who have been contacted for their comments, as part of this Key inspection of Ashdale House. 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 House DS0000021440.V303823.R01.S.doc Version 5.2 Page 8 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 Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good; people who are referred to the home are fully assessed enabling decisions to be taken in respect of the home’s ability to meet the individual’s needs, prior to accepting admissions. All specialised services offered are demonstrably based on current good practice, reflecting relevant specialist and clinical guidance. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The pre-admission assessments, carried out to ensure the home can meet an individual’s presenting needs, are thorough; all parties concerned are consulted with before any decisions are taken regarding a new admission e.g. the applicant, their next-of-kin, their caseworker and any practitioner, or specialist healthcare worker. Psychological and social care assessments are also included as part of this process, prior to admission; this, usually being for a trial period, following visits that are arranged for the individual and their relatives to meet with other residents and the staff, within the home. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good; the staff have a good understanding of the residents’ support needs and this is evident from the positive relationships, observed between staff and residents. The needs of residents are well met with evidence of good multi-disciplinary working taking place on a regular basis. These judgements have been made using available evidence including a visit to the service. EVIDENCE: Care plans and individual risk assessments are regularly reviewed. Residents are registered with GP’s, and there is regular involvement from the Community Learning Disability Team practitioners and consultant psychiatrist. Members of the team, spoken with after the inspection visit, confirmed that good working relations exist with the management and staff at Ashdale House. The managers and the support staff have a good understanding of residents’ needs. It was explained that the home provides support on the basis that it is able to meet residents’ needs. Staff spoken with said that wherever possible,
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 11 encouragement is given for residents to indicate their preferences and to make informed choices. Within their capabilities, residents are encouraged to participate in the day-today running of their home e.g. with household tasks, cleaning and laundry. The Inspector was told that the introduction of any proposed changes in response to a resident’s expressed, or perceived needs are discussed during handovers and during staff meetings, or key worker meetings. Where it is beneficial, some of the residents have a dedicated team of support workers, which facilitates high levels of continuity in the care provided. Support staff receive training in care planning and risk assessment as part of their foundation training. Many of those working at the home are qualified healthcare practitioners in their own right, where they have previously qualified in their country of origin e.g. the Philippines. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good; residents lead a fulfilling life, where both the in-house and community activities provide a widely varied and appropriate source of stimulation, interest and pleasure for residents. Residents have been assessed on an individual basis by the Community Dietician to ensure that any special dietary needs are being addressed and that a sufficiently nutritious diet is provided. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The ethos of the home is to provide an enabling environment that gives encouragement for residents to aspire towards achieving their potentials. Daily routines and activities are agreed in the context of detailed risk assessments, recorded as part of care planning. All individual risks are assessed in a continuous process that ensures unacceptable risks are avoided. The home has developed a comprehensive system of risk management, which is well documented.
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 13 The rights of each resident are protected with their being involved in decisions concerning everyday choices, staff support being provided, as needed, in reaching agreement in respect of individual weekly programmes of activity. Parents may receive copy programmes upon request; the deputy manager confirmed that the home benefits from a high level of support and interest from relatives. Staff at the home encourage residents in the development of their communication skills and the use of sign language e.g. Makaton is widely used in working with the residents. Regular trips home are arranged, where this is possible and daily outings form part of residents’ programme, the home having people carrier vehicles for the purpose. Some disruption in the activities programme was noted on the day of the inspection, as one of the vehicles had broken down. On making enquiries the Inspector was informed that this was not unusual as the vehicles were worn out and unreliable. Furthermore, there was not always staff available on duty who were qualified to drive. For a service provision of this size, which includes two outreach services and four vehicles overall, it would improve the continuity of day-to-day activities for there to be an employed driver, to be responsible also for vehicle maintenance. Mealtimes are seen as an opportunity for residents to develop social skills; staff are on hand to assist and prompt, where needed. One resident enjoys a more independent lifestyle in the home’s self-contained flatlet, where this person can be more involved with meal choice and preparation. Some residents assist with food shopping and with tasks in meal preparation, together with one of the support workers, who is allocated to catering duties on a daily basis. The Inspector is of the view that supervising a challenging resident, whilst at the same time catering for a large group of people, is questionable practice; the two activities should be separated for reasons of health and safety. This then being the case, catering cannot be seen as a good use of a support worker’s time and it is strongly recommended that a competent and qualified cook be employed. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent; the health needs of residents are well met with much evidence of good multi-disciplinary working with the Community Teams, local GP surgeries and psychiatric support services on a regular basis. Personal support in respect of residents’ physical and emotional needs, ensuring their safety and well-being is of a high standard. All staff responsible for the administration of medicines have received training to ensure high standards are maintained in this area of their work. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The home has good working links with healthcare professionals, including the Community Learning Disability Services and the GP surgeries, which are responsive and supportive of the home. Regular routine appointments are arranged for residents with their doctors, dentists and specialist therapists; annual health checks and reviews of medication are arranged also. Residents’ individual care needs and how these are being met are well documented in their care plans. Continuity of care is supported through a key worker, or key
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 15 team system. Residents’ daily activities include some physical exercise in order to promote fitness and weight management; swimming is also encouraged. The Inspector continues to be impressed by the quality of care given on an individual basis; staff were observed taking particular care in providing personal support to residents in the way they prefer and require, whilst being given encouragement to maximise control over their own lives. Detailed handover meetings at change of shift ensure that continuity is maintained. Each of the staff spoken with presented as knowledgeable about the needs of the residents and committed in addressing these. Care planning reviews are well documented and ensure that resident’s changing needs are responded to in a timely fashion. The residents’ health care needs are carefully monitored; appointments being arranged for specialist advice, dental treatment, chiropody and sight tests, which take place in the community. Residents do not have responsibility for their own medicines, they are kept in a secure cupboard in the staff office, and are dispensed to residents as prescribed by a staff member, trained for the purpose, and witnessed by a second carer. It was noted that the Medicine Administration Records were up to date and signed for all the residents. It was clear that the staff responsible understand the importance of adhering to procedures. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good; the home has a satisfactory complaints system with evidence that residents feel their views, or concerns are listened to and acted upon. Where complaints have been received from external sources these have been dealt with efficiently and to the satisfaction of those concerned. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The recording of four complaints that have occurred since the last inspection was examined; each was satisfactorily recorded together with actions taken and outcome. There have also been two Adult Protection alerts, again each of which has been followed up using the correct procedures. Incidents where residents have been involved in physically challenging behaviour towards one another, or towards staff, have been recorded and the required reporting procedures followed up. All staff receive training in challenging behaviour and adult protection matters. One of the complaints that involved a next-of-kin and the placing Authority provided good evidence of the professional way in which sensitive matters are dealt with by the home. However, it is recommended in future, that in a case such as this, where a complaint has been brought to the attention of the Commission, though is being dealt with by the home’s management, that the Inspector be kept informed, at the time. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate; the standard of the environment within this home is satisfactory, providing residents with a safe and suitable place to live. The on-going improvements to the furnishings and interior décor and those planned for the communal garden will enhance the sense of homeliness for the benefit of those who live at Ashdale House. These judgements have been made using available evidence including a visit to the service. EVIDENCE: Efforts are being made to improve the home’s appearance; since the last inspection, the kitchen has been re-fitted, several rooms redecorated, some in bold colours, and actions are being taken to improve the front and rear garden. For health and safety reasons, in respect of the potential for physically challenging behaviour, both the residents’ communal areas and their private rooms are simply furnished are likely to appear stark. The home has a sensory room, which is frequently used for supervised therapy sessions and for calming residents, who become agitated.
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 18 The home is kept clean and hygienic by the care staff, with the supervised assistance of residents, should they be so inclined. Employed workers maintain the house and garden, where there is heavy wear on the fabric of the premises. Regular environmental and fire safety checks are carried out and recorded by a member of the senior staff. Residents’ rooms are individually decorated and furnished to suit their tastes and needs; encouragement is given for residents to take some responsibility for their rooms. Some specialist equipment has been provided, where a resident with restricted mobility is receiving physiotherapy; the Inspector was told by one of the senior support workers that further items of equipment are planned. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good; the commitment of staff towards their work is apparent resulting in a motivated, well-supported workforce that works positively with residents to improve their whole quality of life. Many of the support workers have healthcare qualifications, gained overseas in their countries of origin, resulting in a well-qualified and professionally adept staff team that contributes greatly towards the overall performance of this ‘specialist’ service provision. These judgements have been made using available evidence including a visit to the service. EVIDENCE: Duty rotas show that staffing arrangements during the day and at night- time are satisfactory in meeting the needs of the residents. The majority of residents require additional staff support during the day and this is reflected in a high staff ratio. The home employs a large and multi-cultural staff team of around 40 personnel; the turnover of staff, since the last inspection in January has been low, with two new staff recruited. An additional, forth senior support worker has been appointed to compliment the management team.
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 20 In speaking with the senior workers, the Inspector was impressed by their enthusiasm towards their responsibilities. Staff recruitment practices are thorough and follow the organisation’s guidelines i.e. those of the Alliance Home Care group. The sample of staff files checked showed that the required references and Police checks were in place. However, it appeared that there were no Contracts of Employment for many of the newer staff. When questioned about this, the manager explained that the organisation’s central HR department had previously been responsible for this task and that now it was a duty of the home manager, not yet completed. The home provides a home-specific induction to ensure that all new staff are aware of their roles and responsibilities. Additional to this, induction and foundation training that meets the TOPSS specification has been introduced. There are currently five staff working towards NVQ qualifications and approximately 50 of staff group as a whole has achieved either NVQ, professional social work, or healthcare qualifications in a range of complimentary disciplines. All staff receive regular, formal supervision. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42 Quality in this outcome area is good; the registered manager is qualified, experienced and competent, who together with her deputy, administrative assistant and four seniors provides a proactive management team and stability in this busy and demanding care service. Residents benefit from a well run home where the day-to-day operations appear particularly well planned and staff are clear about their duties. These judgements have been made using available evidence including a visit to the service. EVIDENCE: There has been a positive response from the manager to a request from senior staff for a higher levels of support in carrying out their duties; a forth senior has been appointed and the deputy manager has been given additional duties, specifically in regard to providing such support. This has, in effect, greatly increased the deputy’s span of responsibility and the manager said that it is
Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 22 planned for a second deputy to be recruited, also with specific responsibilities e.g. for housekeeping. Both the manager and her deputy are undertaking specialised training, related to their work, in order to develop further their knowledge of challenging behaviour and autism. A high standard of record keeping in the home was evidenced by the records inspected e.g. those concerning residents, which were well maintained and up to date. The Inspector noted the positive impact that the recently employed administrative assistant had made on the systems and organisation within the main office. One of the senior managers of the organisation carries out and records the required monthly visits to monitor the home’s performance; copies of the reports and any (notifiable) incident reports are forwarded to the Commission. An annual development plan has been produced, which sets out goals in respect of staff recruitment and training, residents’ activities and lifestyles also quality assurance and house maintenance. However, it is recommended that this be reviewed with target dates included. Additional quality assurance measures, including satisfaction survey questionnaires and resident feedback have yet to be introduced. The deputy said that communications with residents’ families was good and this was confirmed in comments made by parents with whom the Inspector as part of this inspection. Staff receive training specific to the health and safety aspects of their jobs and in safe working practices i.e. risk assessment, fire safety, the management of challenging behaviour, medications, health and safety. There are policies and procedures in place that support the health and safety of those who live and work in the home, satisfactory records being kept of assessments that are made on a monthly basis. Not all hot water outlets, used by residents, have safe temperature controls fitted as is required. The manager stated that this work was to be carried out as a matter of priority, within seven days. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 4 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 2 X X 2 X Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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. 01 Standard YA30 Regulation 13(3) Requirement That food preparation, as an activity for residents, is kept entirely separate from the catering arrangements for the resident group and duty staff. That there is a Contract of Employment issued to all staff employed to work at the home, with a copy kept on personnel files. That additional feedback mechanisms are introduced, that will inform the quality of care provided at the home and its overall performance e.g. staff views as to the conduct of the home. (Previously recommended and on-going) Timescale for action 01/12/06 02 YA34 17(2) Schedule 4 para 6 01/12/06 03 YA39 24(1) and 21(1) 01/12/06 04 YA42 13(4) That temperature control valves 01/12/06 are fitted to all hot water outlets, used by residents, to ensure hot water is delivered at a safe temperature to prevent scalding. Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 01 02 Refer to Standard YA14 YA17 Good Practice Recommendations That any vehicles provided for residents daily activities are fit for the purpose i.e. reliable, safe and comfortable. That a suitably qualified cook is employed to ensure a supply of nutritious, varied, balanced and attractively presented meals. That where complaints, being dealt with by the home, have been brought to the notice of the Commission the Inspector is to be kept informed and notified of the outcomes. (See also Regulation 37) That a full-time driver be employed, who also has responsibility for vehicle maintenance. That the home produces an annual development plan with timescales that are reviewed at regular intervals, reflecting the aims and outcomes for residents. 03 YA22 04 05 YA31 YA39 Ashdale House DS0000021440.V303823.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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