Inspection on 12/07/05 for Ashdown

This inspection was carried out on 12th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashdown 08/10/08

Ashdown 17/10/06

Ashdown 03/03/06

Ashdown 10/11/04

Ashdown 06/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Ashdown 17 Woodway Road Teignmouth Devon TQ14 8QB Lead Inspector Sam Sly Unannounced 12th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashdown Address 17 Woodway Road, Teignmouth, Devon, TQ14 8QB 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) 01626 772995 01626 779629 enquiries@ashdowncarehome.co.uk Mr David Rogers Mrs Saw Choo Rogers Vacancy Care Home 12 Category(ies) of Learning disability (12), Learning disability over registration, with number 65 years of age (12) of places Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Aged 25 Date of last inspection 10th November 2004 Brief Description of the Service: Ashdown provides care for up to 12 adults aged 25 to 65 and over with a learning disability. It is a detached house is a residential area of Teignmouth, close to local amenities including bus and train routes. Residents have the use of a minibus for transport, but also use taxis or walk into town. Ashdown is set out over a ground and first floor linked by stairs. There is a dining room, one small, one large lounge and one sun lounge, a kitchen, two office areas, a bathroom with bathchair and a disabled shower room, toilets and bedrooms; all of which are single except for one shared bedroom. There is parking to the front of the home, and a sun terrace and garden to the rear. The Owners, Mr and Mrs Rogers, live on the premises. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place in the afternoon of a weekday in July. Mr Rogers the owner was present throughout. Judgements were based on observation of staff/resident interaction, written records, discussion with residents, staff and the Owner Mr Rogers, and a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: To make sure all staff were working to meet residents current needs, goals and aspirations resident’s risk assessments and care plans must be comprehensive. To ensure the Owners and CSCI have a clear picture on residents and stakeholder’s views, and what is being done well and what needs improving a quality assurance system must be put in place. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 6 To ensure the safety of residents, the fire door held open with a wedge or furniture must have an approved opening device fitted. 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. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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 Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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) 2 Although no new residents had moved to Ashdown for some years, an appropriate format was available to assess potential resident’s needs and aspirations. EVIDENCE: The newest resident had moved to Ashdown several years previously, so no recent assessments were available to examine. However, resident’s files showed in the past Local Authority assessments and plans had been obtained and there was an appropriate format available to assess needs. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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 and 9 Not all care plans and risk assessments reflected the changing needs of residents, so residents could not be confident that all staff were clear about their current care needs and goals. EVIDENCE: From discussion it was clear that the senior staff member and Mr Rogers knew residents well, and could verbally describe in detail their current needs. However three resident’s care plans and risk assessments were examined and found not to reflect these current care needs and risks. There was an extensive range of forms and tick boxes to record such things as activities, goals, how needs will be met, and inventories of belongings, however, some forms were not used or relevant to particular residents, some parts were not fully completed or up to date and there was no clear plan for the resident showing staff what needs and goals residents had, how they would be met and by who. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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) 12, 13, 15 and 16 Residents lead active, varied lives, which include a range of opportunities in the home and the community. Residents can develop and maintain relationships, and their rights are respected in their everyday lives. EVIDENCE: Residents did a range of day activities; some attended local authority provided day opportunities, one resident attended a voluntary job and some residents were active in the local community and went out independently, others did activities at Ashdown such as art and craft, exercise, listening to music, and karaoke. Residents went out on trips to local attractions in the home’s minibus or staff cars. There were educational classes available at the local College, but at present no one attended. Residents said they enjoyed the day activities they attended, and liked going out on trips. Laminated mats had been made for each resident showing the activities available and what each person did however, these mats were not up to date, Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 11 and neither were the tick sheets within residents care plans showing what activities they had attended. Residents had access to all parts of the home and garden and all bedroom doors had locks to provide privacy. Staff were seen to be interacting with residents throughout the Inspection and residents said the staff were nice. Only a few residents were in regular contact with their families, however family involvement was encouraged and residents phoned or wrote to relatives with the help of staff. Residents said they liked the people they lived with, and some had made friends at their day services or in the community. Some residents attended local Churches. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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 and 20 All residents receive the personal and health care support they require, and medication is administered safely. EVIDENCE: Many of the residents have lived at Ashdown for many years, and ageing has increased their personal and healthcare needs. The Owner and staff had taken steps to address these needs with changes to the environment and increased use of the local learning disability and health services. Staff were observed to be supporting residents personal care needs with respect and dignity during the Inspection. Records showed that resident’s health was monitored closely and appropriate support given by professionals when needed. The medication records and facilities were examined and found to be appropriate. Staff administering medication had received training. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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 and 23 Arrangements for listening and acting on residents concerns were appropriate, and residents were protected from abuse. EVIDENCE: There was an appropriate complaints procedure included in the Statement of Purpose and Service User Guide, and a complaints book was in use. Neither the Commission nor Mr Rogers had received any formal complaints since the last Inspection. There were adult protection policies and procedures including whistle blowing and the Local Authority Alerter’s Guidance. Staff were able to state the correct procedure to follow if abuse was discovered. Mr Rogers said that the adult protection procedures were discussed at Induction and staff said they had covered it during NVQ training. None of the staff had attended the Local Authority ‘Protection of Vulnerable Adults’ training and it is recommended that at least the Owner or a senior member of staff attend to ensure staff are fully up to date with the procedures. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 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 and 30 The premises are suitably adapted, maintained and furnished for it’s stated purpose, so residents living there have a homely, safe, comfortable home. EVIDENCE: The communal areas of the home were kept regularly redecorated and looked bright, cheerful clean and comfortable. All but one of the communal bathrooms/toilets had been redecorated. Bedrooms were clean and reflected the personalities of residents. The décor in some bedrooms was looking a little tired, and the Owner said he had problems redecorating with residents in situ, however some residents were going on holiday later in the year and it was suggested work took place then. A door wedge was found in one bedroom, although it was not in use at the time. Mr Rogers explained that it was provided to stop the resident using furniture to hold the fire door open. This practice is not acceptable due to the risk to residents. Ashdown is close to the town centre of Teignmouth and residents walk or use public transport, taxi’s and the home’s mini-bus to get around. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 15 The Environmental Health Department had visited recently and left some recommendations that the Owner’s were working to meet. The laundry facilities in the home were hygienic and helped to prevent the spread of infection. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 16 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) 32, 33, 34 35 and 36 Staff were sufficiently supported, experienced, trained and competent to meet the needs of residents. EVIDENCE: The had and and Home had a small, but experienced staff team. Four out of the seven staff either NVQ 2 or 3 and the senior carer had the Registered Manager Award was an NVQ Assessor, and training was seen as important to Mr Rogers staff spoken to. Staff were observed to interact with residents at all times with lots of laughter and genuine relationships demonstrated. Residents said staff were nice and they felt able to tell them any problems. Staff spoken to were knowledgeable about residents. On arrival three care staff were on duty, reducing to two in the afternoon. There was also a cook and Mr Rogers was in the Home. Staff and residents said the number of staff was sufficient to meet the needs of residents. Three staff records were examined, and all the Criminal Record Bureau checks held in the home. Two staff files were comprehensive, however one staff member had been re-employed and new recruitment checks had not been Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 17 carried out. It was recommended that in the future new and re-employed care staff follow the same recruitment procedure. Some Criminal Record Bureau checks raised issues about staff suitability. Mr Rogers could verbally explain his decision-making for employing these staff but had not recorded this. The Owner and senior carer admitted that formal supervision had not happened on a regular basis recently, although informal supervision was almost daily and there were weekly meetings between Mr Rogers and the senior carer. There was a twice-yearly appraisal system in place. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 18 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) 39 and 42 The Owners methods for monitoring quality were not underpinned by the views of residents or others with a stake in Ashdown, and did not enable them to identify what they are doing well or needed improvement. The resident’s health, safety and welfare was protected and promoted by the Owners. EVIDENCE: Although there were a few quality-monitoring processes and the Owners were in the home everyday, there was no overall quality assurance system in place. Mr Rogers said he had sent questionnaires out two years previously and got little response so had not tried again. All health and safety records and checks were examined and found to be up to date and staff had received a range of health and safety training. Mr Rogers admitted some staff needed their First Aid and manual handling training refreshed, and that he would arrange this. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 19 Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 20 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashdown Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 21 no 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. 2. 3. Standard 6 9 39 Regulation 15 13 (4) 24 Requirement A comprehensive care plan with goals, must be completed with each resident. A comprehensive risk assessment must be carried out with each resident. There must be a complete Quality Assurance system in place that captures views of residents and stakeholders. An annual report must be produced, with a copy available for CSCI and other interested people. Door wedges and furniture must not be used to hold open fire doors. A Fire Service approved device must be fitted. Timescale for action 21st September 2005 21st September 2005 21st December 2005 4. 24 23 (4) 21st September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 6 12 and 14 Good Practice Recommendations Each residents inventory of belongings should be updated. Each residents activity programme (and laminated mat) should be updated to reflect their current work, leisure and educational activities. D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 22 Ashdown 3. 4. 5. 16 23 34 6. 7. 36 The identified toilet door should have a lock fitted. The Owners or senior staff should attend the Local Authority Protection of Vulnerable Adults training. The Owner should ensure that decision-making with regard to employing staff with issues regarding their fitness is recorded. The employment checks and procedures for new staff should be followed for re-employed staff. All care staff should have regular supervision. Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Ashdown D54-D07 S3643 Ashdown V214881 120705 Stage 4.doc Version 1.30 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!