Inspection on 30/07/05 for Ashdale House

This inspection was carried out on 30th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashdale House 18/07/06

Ashdale House 31/01/06

Ashdale House 07/10/04

Ashdale House 24/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ashdale House 14 Silverdale Road Eastbourne East Sussex BN20 7AU Lead Inspector Mike Flint Unannounced 30 July 2005 13:00 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 House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 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 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 (LD), 10 registration, with number of places Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accomodated is ten 2. Service users in addition to having a learning disability may also exhibit forms of challenging behaviour 3. Residents should be aged over eighteen and under sixty five on admission Date of last inspection 20th October 2004 Brief Description of the Service: Ashdale House is a large detached property situated a short walk from Eastbourne seafront and the town’s shopping centre. Accommodation is on four floors, including a small self-contained flat and nine single bedrooms. 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. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over four and a half hours, during one afternoon in late August 2005, when there were ten (10) residents. The registered manager and deputy assisted with the inspection; each of the duty seniors was spoken with. The Inspector was also introduced to those residents who were present, though conversation was restricted due to their disabilities. One of the residents was off site, spending time at his home for a birthday celebration. The inspection included a tour of the premises and an examination of records and care practices. Shortly after the inspection a resident’s social worker was spoken with, who commented favourably on the care that residents receive at Ashdale House. What the service does well: What has improved since the last inspection? From discussions with the manager and deputy it is apparent that much thought and effort is being put into defining and recording the complex care needs of each, individual resident and how support workers are (expected) to meet these. A trial was being successfully run, whereby one of the more independent residents was receiving support from a dedicated staff team. Detailed programmes of activity were shown to the Inspector, demonstrating the priority being given to improving the quality of life of each resident. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 6 This aim being reflected also in the on-going improvements to the fabric of the home, being made in order to create a more homely environment; communal areas have been redecorated in bright, cheerful colours and there are plans to improve facilities within some of the residents’ private rooms. An annual development plan that has recently been produced, details a variety of aims and objectives to be met. The Inspector suggested that the inclusion of timescales would be beneficial to the overall planning strategy. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 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 House H59-H10 S21440 Ashdale House V235222 300805 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) 1, 2, 3, 4, 5 People who are referred to the home are fully assessed enabling decisions to be taken in respect of the home’s ability to meet individual resident’s needs. EVIDENCE: The manager and deputy spoke about the further work being carried out in order to present a Home Guide for residents, including terms and conditions, in a graphical image format e.g. using Widget software. The manager carries out detailed pre-admission assessments. Relatives and prospective residents are consulted with as much as possible; social care assessments are made available and there are discussions with Social Services in every case. When a vacancy occurs introductory visits are arranged for those being referred, followed by a trial period; during this time further assessment is carried out and a draft care plan is drawn up. Where there is a specific health care need e.g. epilepsy, residents receive ongoing support from their medical Consultant. Each resident has a key worker, who is responsible for completing the care plan and risk assessments. All staff receive in-house training relevant to their work. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 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) 6, 7, 8, 9 The staff’s understanding of residents’ support needs is derived from wellpresented care planning documentation and the effective sharing of day-to-day information concerning each resident at shift handover, also from the positive relationships that develop between staff and residents. EVIDENCE: The home completes detailed pre-admission assessments, forming the basis for initial care planning. The care plan format is well presented for easy staff access to information e.g. the inclusion of helpful ‘getting to know you’ files. Risk assessments are completed for all aspects of individual support, healthcare needs and off-site activities. Residents are supported in making choices about their day-to-day living. Routines within the home allow for a good degree of flexibility. Staff at the home liaise with staff at other locations, where residents access daytime activities, and with the Community Healthcare services. Based on risk assessment and personal choice, residents can participate in daily household tasks, including food preparation, washing up and laundry. Residents have individual house-days for cleaning and tidying their own rooms with staff support. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 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) 11, 12, 14, 15, 16, 17 Links with the community are good, supporting and enriching the residents’ social lives and their opportunities for recreational activity. EVIDENCE: Regular reviews are conducted that record resident’s needs and abilities; these are regularly assessed and goals are agreed at this time also. The home’s ethos is based on personal and social development and the acquisition of life skills. From contact with a social worker, who regularly visits the home, it is evident that individual progress is being achieved in these areas. Records show that a variety of daily activities are available for residents to choose from. Some attend college courses; most enjoy sensory therapy sessions each week. There are also trips, holidays and outings arranged. Each resident has a key worker with whom there is regular one-to-one time set aside within their individual activity programme. Residents are encouraged to maintain contact with friends and relatives through visits, or by telephone. The home has a mini bus, which is in daily use and is often used to facilitate weekend trips home for residents. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 11 Staff spoken with said that resident’s right to privacy was always respected and that they were encouraged to treat the home as their own, choosing to spend time together, or in the privacy of their own room. Staff were seen to be attentive to the needs of residents, giving encouragement to develop their self-help and social skills. Residents may choose to assist in the preparation of meals. There is a weekly menu plan and a record is kept of any special diets or preferences. The manager said that she is currently carrying out a screening exercise for individual allergies. Mealtimes are flexible e.g. breakfasts and lunches, depending on what service users have planned for the day. The Inspector has previously questioned whether the present arrangement, whereby the various duty care staff prepare meals, ensured that a wholesome, nutritious and varied diet was being achieved. The manager said that staff knew the service users’ likes and dislikes, when it came to mealtimes. Consultation with the Community Dietician is again to be recommended. Some staff spoken with were unclear as to whether they had received training in basic food hygiene. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 12 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) 18, 19, 20 The health needs of residents are well met with evidence of regular multidisciplinary working with the Community Teams and GP Practices. EVIDENCE: The manager confirmed that the home has good working links with healthcare professionals, including the Community Learning Disability Services and the GP surgeries, which she said were 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 system. Residents’ daily activities have been revised to include some physical exercise during several short sessions, in order to promote fitness and weight management; swimming is also encouraged. Staff, who have responsibility for medications, have received suitable training. The home has a policy for the receipt, storage, recording, handling, administration and disposal of medicines. Personal care is offered discreetly to residents in their private rooms; staff were observed always to knock before entering bedrooms, or bathrooms. The times for bathing, going to bed, getting up and for meals is of residents’ own choosing, whenever possible. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 13 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) 22, 23 The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted upon. EVIDENCE: The staff/ key workers are trained to respond positively to the wishes, suggestions and concerns that residents may present. A record is kept in the home of any complaints made, when they have been subject to action, or investigation. Details of the complaints procedure are included in the terms and conditions of residence. All new staff undergo Criminal Records Bureau checks before commencing their employment. The manager arranges staff training in the protection of vulnerable adults and adult abuse. There is clear policy guidance for staff to adhere to. A recent incident of self-harm by a resident, reported to the Commission, was managed appropriately at the time and the detailed risk assessments, already in place, were revised accordingly. The home keeps records of all monies, managed on behalf of residents e.g. pocket money savings and expenditure. One resident spoken with said that he was saving hard for his holiday. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 14 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, 26, 28 The premises are adequately suited to the home’s stated purpose and in meeting the needs of the service users. However, there are outstanding maintenance tasks requiring attention and the residents’ garden appears rather neglected, which does not reflect positively on the service provided. EVIDENCE: There is an improvement in the standard of décor, since the last inspection. However, some communal areas and residents’ private rooms remain in need of redecoration. A maintenance person is employed, who is responsible for this and for the frequent repairs to be carried out in the house; it is acknowledged that the residents place heavy wear and tear on the fabric of the home. The manager has produced a detailed maintenance schedule and work was in progress, including plans to improve the two residents’ rooms, without en suite facilities. It was noted that the long outstanding requirement for radiator covers to be fitted, has yet to be carried out, also that extractor fans are required in each of the existing en suite facilities. Most residents have personalised their rooms according to their lifestyles; some further encouragement in this regard would contribute towards creating a more homely environment. Staff have carried out some work to improve the ambience in the communal rooms. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 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) 31, 32, 33, 34, 35, 36 The manager supports a mostly enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: The staff employed bring a range of qualities and experiences to the home and a significant number have achieved relevant professional qualifications e.g. occupational therapy, nursing, teaching, psychology, speech and language therapy. Several have attained NVQ awards at levels 2, or 3 in Care, others are working towards these qualifications. The attitude of staff, observed during the inspection, towards residents was attentive and calm; an effective staffing ratio to residents is maintained throughout the week. Staff appeared competent in their work, though the Inspector noted that not all of those he met had good English speaking skills; the manager said that foreign nationals, working at the home had been encouraged to speak only in English, when at work, and that this was helping to establish better communication. The home employs a high proportion of foreign nationals, who are recruited and screened by a reputable recruitment agency. The Organisation arranges and provides in-house training in the required core skills and there is a staff training and development plan; a thorough recruitment process is followed in all of the homes, owned by the Alliance Home Care group. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 16 The manager discussed with the Inspector some personnel issues that had arisen within the staff team; appropriate measures were being taken in addressing these. Staff receive regular supervision from either the manager, or deputy; roles and responsibilities are clearly defined. Regular staff meetings take place. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 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) 37, 38, 39, 42 The manager appears to have a good understanding of the areas in which the home needs to improve, judging by the progress that is being achieved. EVIDENCE: The manager is experienced and competent to run the home and has a relevant professional qualification in care and has undertaken management training. The home’s written policies and procedures are those of the Alliance Home Care organisation. These are comprehensive, well documented and reviewed at least annually. They cover all aspects of running the care home and are readily available for staff advice and guidance. An annual development plan has been produced, which sets out some goals in respect of staff recruitment and training, residents’ activities and lifestyles also quality assurance and house maintenance. The Inspector suggested that the addition of timescales to the objectives would be helpful. Further quality assurance measures, including satisfaction survey questionnaires have yet to be introduced. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 18 The standard of record keeping in the home is good as was evidenced by the records inspected concerning residents, which were well maintained and up to date. Monthly visits are satisfactorily carried out by the registered provider with detailed records kept, copies of which are forwarded to the Commission. 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. Though the Inspector was unable to establish whether all staff training were trained in basic food hygiene. There are policies and procedures in place that support the health and safety of those who live and work in the home. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 19 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 2 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashdale House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 20 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 26 Regulation 13(4, a-c) Requirement That radiator guards are fitted in all areas accessed by residents, where there is a risk of injury from scalds. (Previous timescale not met) That any toilets, bathrooms, including en suite facilities, where there is no natural ventilation, are to be fitted with positive air-extraction units. Timescale for action 01.02.05 2. 26 23(2, p) 01.02.05. 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. 2. Refer to Standard 17 42 Good Practice Recommendations That the Community Dietician is consulted with to ensure that the diet provided is sufficiently nutritious. That all staff involved in the preparation of food receive approved training in basic food hygiene. Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 © 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 Ashdale House H59-H10 S21440 Ashdale House V235222 300805 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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