Inspection on 31/01/06 for Ashdale House

This inspection was carried out on 31st January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashdale House 18/07/06

Ashdale House 30/07/05

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 Announced Inspection 31st January 2006 13:00 Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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.V268831.R01.S.doc Version 5.0 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.V268831.R01.S.doc Version 5.0 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.V268831.R01.S.doc Version 5.0 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 30th August 2005 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. 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 DS0000021440.V268831.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over 4 hours during one afternoon in late January when there were ten residents. Staffing arrangements were satisfactory; the Inspector attended the staff handover meeting at shift change. Four of the duty staff were spoken with in private, including the deputy manager, who was in charge at the time of the inspection. Comment cards were received from six of the residents’ parents, four of whom were spoken with individually. Most of the residents have limited communication however, the Inspector was able to speak with two residents, who appeared relaxed and happy with the activities in which they were involved. What the service does well: What has improved since the last inspection? What they could do better: Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 6 Quality monitoring measures are to be developed further and used as a means of reviewing progress and taking actions that will continue to improve the overall outcomes for residents of Ashdale House, in particular respect of input from the residents themselves, aided by independent advocates, where this may be needed. Footnote The Inspector would like to thank the staff and residents for their cooperation during the inspection, also the manager for having provided a considerable amount of comprehensive and well-presented information about the service at Ashdale House, beforehand in order to facilitate the inspection, and not least those parents who contributed their comments. 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.V268831.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Each of these Standards was assessed as having been met at the time of the last inspection in August 2005 and these have therefore not been re-assessed as part of this current inspection. However, it was noted that, since the last inspection, the home’s Statement of Purpose has been produced in a format, better suited to the understanding of residents i.e. with the use of symbols. EVIDENCE: Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Residents are supported by the home to make individual choices regarding their daily lives; all such these choices are risk assessed in order to safeguard residents from possible harm. 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. 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 i.e. at the local College, or 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 DS0000021440.V268831.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15, 16, 17 Residents are encouraged to engage in meaningful activities and are enabled to maintain and develop social and independent living skills. Mealtimes promote the social well being of residents; a review of menu planning is recommended to ensure a nutritious and well-balanced diet is provided. EVIDENCE: Each of the residents has a variety of opportunities to maintain and develop social and independent skills. In the home, residents are encouraged to help with different household chores such as cleaning, tidying their rooms and supervised kitchen chores. The local College provides opportunities for further education and a list of current courses including computer skills and literacy classes is posted up in the general office. 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. Residents’ individual interests are encouraged in their detailed weekly programme of activities. 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. Regular trips home are arranged, where Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 11 this is possible, the resident’s key worker undertaking responsibility for transport when necessary. Daily outings form part of residents’ programme, the home having three suitable vehicles for the purpose. Staff spoken with confirmed that each resident has holidays arranged away from the home. Mealtimes are seen as an opportunity for residents to develop social skills. Staff are on hand at all times to assist and prompt, where needed. One of the residents enjoys a more independent lifestyle in the home’s self-contained flatlet, where this resident can be more involved with meal choice and preparation. Records are kept of meals served including any special diets. Residents have some choice about what they eat. A four-week menu plan serves as a basis for staff to plan around. In order to ensure that all the residents’ nutritional needs are met, the Inspector recommends contact is made with the Community Dietician and that all staff involved in the preparation of meals receive training in this aspect of their work. Some residents assist with food shopping and with tasks in meal preparation. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20 The home provides a commendable standard of personal support in respect of residents’ physical and emotional needs, ensuring their safety and well-being is the foremost consideration. Medicine administration procedures are thorough and records are regularly checked by medically qualified staff to ensure compliance with standards. EVIDENCE: The deputy manager confirmed that the home has good working links with healthcare professionals, including the Community Learning Disability Services and the GP surgeries, which he 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 include some physical exercise in order to promote fitness and weight management; swimming is also encouraged. Only staff who have received training on the administration of medicines are authorised to do so. The record of administration of medicines was inspected and found satisfactorily completed. Medicines are held securely. No residents currently self medicate and no controlled drugs are held at present. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 Any matters of concern are handled appropriately, reassuring those involved that they are being listened to and that action will be taken, as necessary. EVIDENCE: There have been no complaints recorded, or received by the CSCI since the last inspection. The home has a written procedure that advises residents, their families, or other visitors to the home how to make a complaint; a copy of this is displayed. The parents spoken with said that the manager and staff were very approachable and responsive, should issues arise that required action. The organisation employs a full-time counsellor, who is available in support of both staff and residents. There are detailed policies and procedures in place relating to adult protection and abuse; staff have received training in these areas of their work. Police checks are carried out for all staff employed in the home. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26, 27, 28, 29, 30 The home provides a safe environment that is accessible and satisfactorily maintained, meeting residents’ individual and collective needs in a comfortable and suitable style. EVIDENCE: Since the last inspection further improvements have been made to the general décor inside the building to achieve an attractive and cheerful environment e.g. wall plaques and areas that have been re-decorated. New floor coverings have been laid and an additional en suite facility provided; the Inspector noted that the required extractor fan has yet to be fitted. Residents’ private rooms are suitably furnished and fitted out, according to individual needs and risk assessment. One of the senior support workers has responsibility for carrying out health and safety and fire safety checks around the home; the records inspected showed that these tasks are routinely undertaken; any tasks requiring attention were recorded in the maintenance book and are promptly completed. The home is kept clean and free from odours by care staff; specific cleaning duties were allocated during shift handover. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 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, 36 The staff have a good understanding of the residents’ support needs, evident from the positive relationships, which have been formed between staff and residents, observed during the inspection. EVIDENCE: The duty rota showed that staffing arrangements during the day and at nighttime 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; some natural turnover occurs and when there are vacancies the existing staff provided relief cover. The deputy manager confirmed that eight new staff have been appointed since the last inspection and a small number of vacancies remain to be filled. The Inspector understands that, by its nature the work can be stressful and challenging. Each of the three senior staff, including deputy manager spoke enthusiastically about their work in the home and those staff spoken with presented as committed to the care of the residents. Staff recruitment practices are thorough and follow the organisation’s guidelines i.e. those of the Alliance Home Care group. 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 six staff working towards NVQ qualifications and Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 16 approximately 50 of staff group as a whole have attained professional social work, or healthcare qualifications in a range of complimentary disciplines. A small number of staff are employed both as support workers at Ashdale and as outreach, home care workers by the Company’s registered domiciliary care agency, supporting individuals receiving single service provision at two nearby locations. All staff receive regular, formal supervision. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 The registered manager is qualified, experienced and competent, who together with her deputy, a newly appointed administrative assistant and three seniors provides a robust management team and stability for the home. EVIDENCE: Residents benefit from a well run home where the day-to-day operations appear particularly well planned and staff are clear about their duties. The Inspector attended the afternoon shift handover, which was thorough in detail about meeting each of the resident’s needs, covering also individual programmes of activity; these programmes being flexible, dependant upon individual responses on the day. 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, covering all aspects of running the care home and are readily available for staff advice and guidance. 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 Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 18 positive impact that the recently employed administrative assistant had made on the systems and organisation within the main office. Monthly visits are satisfactorily carried out by the registered provider with detailed records kept, copies of these and any (notifiable) incident reports are correctly 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. Further 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 by comments made by parents in speaking with the Inspector. 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. However, some staff, who are involved in the preparation of meals, have yet to receive training in this aspect of their work. There are policies and procedures in place that support the health and safety of those who live and work in the home. The senior support worker with responsibility for the fire safety and health and safety checks showed the Inspector the satisfactory records kept of assessments that were made on a monthly basis. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 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 X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashdale House Score 4 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 4 3 X DS0000021440.V268831.R01.S.doc Version 5.0 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 YA27 Regulation 23(2p) Requirement That any toilets, bathrooms, including en suite facilities, where there is no natural ventilation, are to be fitted with positive air-extraction units. (Previous timescales unmet) That additional feedback mechanisms are introduced, that will inform the quality of care provided at the home and its overall performance. Timescale for action 01/04/06 2. YA39 24(1) 01/08/06 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 YA17 YA42 Good Practice Recommendations That the Community Dietician is consulted with to ensure that the diet provided is sufficiently nutritious for all residents. That all staff involved in the preparation of food receive approved training in basic food hygiene. Ashdale House DS0000021440.V268831.R01.S.doc Version 5.0 Page 21 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 © 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 DS0000021440.V268831.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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