CARE HOME ADULTS 18-65
Ashgate House 13 Junction Road Romford Essex RM1 3QS Lead Inspector
Ms Rhona Crosse Unannounced Inspection 7th February 2006 02:45 Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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 Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ashgate House Address 13 Junction Road Romford Essex RM1 3QS 01708 756601 01708 749326 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) Ashgate House Limited Mr Rionel N Alcid Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service user category to include one named person over 65 years of age. 27th October 2005 Date of last inspection Brief Description of the Service: Ashgate House is a care home offering 24 hour care to adults with learning and physical disabilities. All bedrooms are single occupancy. The home is situated close to Romford market town and is in easy walking distance of the centre of the town and close proximity to a local park. There are parking restrictions in the streets surrounding the home. There is parking for 5 cars to the front of the property. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced this means that the home did not know the inspector was coming. The inspector arrived at approximately 14.45. The manager had left for the day, but when contacted by staff came back to the home to assist with the inspection. The service users that were at home were all in the conservatory with the occupational therapist. They were carrying out exercises when the inspector arrived. The inspector spoke briefly with the service users and stated that she would speak to them later after they had finished their exercise class. As most of the ‘core’ standards were inspected at the last inspection there were only 3 standards, medication practice and records, recruitment and selection of staff, and how the home self monitors it’s operation (quality assurance) and the requirements from the last inspection to check at this inspection. Staff were spoken with to confirm information provided to the inspector by service users and gain knowledge about the staff’s perception of their role and responsibilities. What the service does well:
The home is operating to an excellent standard. This is reflected in the lack of requirements made at the last inspection in October 2005, when only 2 requirements were made although the majority of ‘core’ standards were inspected. At this inspection the remaining ‘core’ standards were inspected, no requirements have been made as a result of this inspection. The manager and staff are to be congratulated in achieving this. Service users who were able to give an opinion of the standard of care said that they were happy with the care the staff provided. They spoke of their next holiday that had already been booked. “The staff are nice and they look after us here.” “They sit and talk to us; we can say what we want” they will help us to go shopping, we will be going on holiday again”. “We have a choice of food, the food is alright, you can have something different if you don’t like what’s being cooked”. “ I’ve got sausage and mash my favourite tonight”. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 6 “I used to live somewhere else and they used to give me 4 eggs, I don’t get 4 eggs here”. It was discussed with the service user that 4 eggs at one meal is not healthy eating. “Roy’s a good cook, they all cook, some are better at it than others but all the food is good”. “We say what we want for the week and we go out and get it with the staff sometimes”. “We are going on holiday we talked about where we wanted to go and we choose Butlins. It’s all there you don’t have to go out looking for places to eat or things to do it’s all there at Butlins at Bognor Regis”. “We’ve been to Butlins there before, I like it there. The beach is nice it gets hot there I like it” “You have to get sun cream or you go red, I don’t like that.” There were no relatives visiting at the time of the inspection however at the last inspection the inspector spoke with relative that were visiting. Visiting relatives during the last inspection made only positive comments. What has improved since the last inspection? What they could do better:
There is little that the home can improve on, as from this inspection there were no requirements set. Ongoing maintenance is planned and time has been agreed for this maintenance to take place. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 7 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. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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 Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): There are no vacancies at the home and there have not been for some time. These standard when last checked in line with the admissions process were met. Once a vacancy becomes available and is then filled these standards will be inspected again. EVIDENCE: Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): These standards were met at the last inspection and were not inspected at this inspection. However they will be inspected at the next inspection. EVIDENCE: Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 11 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): These standards were met at the last inspection and were not inspected at this inspection. However they will be inspected at the next inspection. EVIDENCE: Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): 20 This standard was met evidencing that medication administration is being carried out appropriately and this protects the health of service users. EVIDENCE: Medication practice was inspected. Medication records corresponded with the medication administered and held in the monitored dosage system. Boxes of medication held separately to the monitored dosage system were checked at random. All ‘boxed’ medication had the date of opening recorded on the box. This is good practice as this allows a clear audit trail of any medication held by the home. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): These standards were met at the last inspection and were not inspected at this inspection. However they will be inspected at the next inspection. EVIDENCE: Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): These standards were met at the last inspection with the exception of Standard 24 as a seal around a bedroom sink required replacing. The home ensures that requirements set are acted upon for the benefit of service users. EVIDENCE: It was a requirement at the last inspection that a seal around a bedroom sink was replaced. This requirement was checked and met at this inspection Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 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): 34 These core standards, 32 and 35 were met at the last inspection and were not inspected at this inspection. However they will be inspected at the next inspection. Standard 34 was met evidencing that the home’s recruitment and selection processes protect service users. EVIDENCE: A selection of newly appointed staff files was inspected. All had a copy of their application form, 2 written references and a CRB disclosure check returned to the home. A copy of their induction programme was held in their file along with any training certificates they had gained. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 16 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): 36, 37 and 39 These standards are met evidencing that the home is being appropriately run and for the benefit of the service users they care for. EVIDENCE: The manager has now been registered with the Commission. He is currently taking the registered managers award training. The manager attends training courses to keep abreast with the changes and improve his skills and knowledge. The manager has a wealth of experience in relation to the service uses living in the home as he has worked at the home for many years in the capacity as a senior carer. Staff are receiving formal written supervision. It is recommended that a ‘supervision chart’ be drawn up with both the supervisor and the supervisee signing and dating the chart when supervision has taken place. This will aid the
Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 17 planning of supervision sessions. Anyone inspecting the supervision process can then see at a glance when these formal sessions have taken place. The registered company has it’s own quality assurance system and a survey had recently been sent out to relatives, friends and health professionals. Not all the questionnaires had been retuned. Once the information has been gathered together a chart should be drawn up to show the areas where a positive response was made and also to evidence where relatives, friends and health professionals felt the home could improve in. This information should then be added to the service users guide. This must take place annually. In discussion with service users, the manager and staff, it was evidenced that service users have as much input into the running of the home as their abilities allow. Although none of the service users would be able to have any input into the policies and procedures of the home, their opinions are sought for the dayto-day operation of the home with staff offering as many choices as possible. Advocacy services are available to service users, in the past two service users have used these. However, currently none of the service users wish to use an advocacy service. Links with the community via day centres give service users an outlet to talk to care providers out side of the home. There are new care plans that take into consideration the ongoing development of service users and these will set goals and evidence the year on year achievements made by service users. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 3 X X X X Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA36 Good Practice Recommendations It is recommended that the home create a supervision chart to evidence when supervision takes place. Both the supervisee and the supervisor would have to sign to state that supervision has taken place on a specific date. This would assist in ensuring that all staff have the minimum of 6 formal supervision sessions in one year. Ashgate House DS0000027832.V282438.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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