Inspection on 12/07/05 for Ashgrange House

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

Ashgrange House 20/02/07

Ashgrange House 12/12/05

Ashgrange House 18/01/05

Ashgrange House 07/06/04

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 Ashgrange House 9 De Roos Road Eastbourne East Sussex BN21 2QA Lead Inspector Mike Flint Unannounced 12th July 2005 09:45 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. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashgrange House Address 9 De Roos Road Eastbourne East Sussex BN21 2QA 01323 732544 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 Mrs Geraldine Connelly Care Home 8 Category(ies) of Learning Disability (LD), 8 registration, with number of places Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is eight (8) 2. Residents may also exhibit some forms of challenging behaviour 3. That the resident identified can continue to live at Ashgrange House although he is over sixty-five years of age Date of last inspection 18 January 2005 Brief Description of the Service: Ashgrange House is a detached property situated in a quiet residential area of Eastbourne, approximately half a mile from the town centre. Local shops and bus routes are a short walk away. Accommodation is provided on three floors, the home does not have a lift and therefore people accommodated at Ashgrange must be independently mobile. The home is registered to accommodate eight adults with a learning disability who may also have challenging needs. The registered providers are Alliance Home Care (Learning Disabilities) Limited. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over four hours, during a morning in July, when there were eight residents present. The registered manager assisted throughout the inspection. Each of the duty staff were spoken with individually, as were three of the residents, whose care plans were inspected. Some of the other residents, having no communication, were nevertheless able to express their contentment and interacted positively with Inspector. There were no visitors to the home, during the inspection. What the service does well: What has improved since the last inspection? 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. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 6 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 Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 7 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, 3, 4 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: From an examination of documents it is clear that detailed pre-admission assessments are carried out and form part of the initial care plan. There have been two new admissions to the home during the last twelve months; the manager said that on each occasion the relatives and prospective service users had been consulted with. Social care assessments were made available, following discussions with the placing Authorities and these were held on file. The manager confirmed that when a vacancy occurs introductory visits are arranged for any interested parties. These visits include joining other residents for a meal and then staying overnight or for a weekend, where this is agreed as appropriate. The home does not accept emergency admissions. After the first three months a review takes place of the resident’s care needs in conjunction with their Care Manager and next-of-kin, or representative. 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, in addition to the NVQ training; the record of this was seen during the inspection. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 8 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 showed a good understanding of the residents’ support needs, reflected in the positive relationships that were apparent between staff and residents. EVIDENCE: Residents’ care plans are comprehensive and include personal histories, daily reports and risk assessments. The documents are particularly well presented. However, of those seen, one had not been completed, as required, by the key worker responsible. It was clear from speaking with residents that they were encouraged to make choices about their daily activities and would manage their own pocket money, with help from staff. Details of an independent advocacy service are kept at the home for any resident, who may need this. Residents assist with household chores and a rota was displayed to remind individuals of their responsibilities. Staff said that support was given to individuals, as and when needed to ensure that rooms were kept clean and that personal laundry was carried out. One of the residents had been very involved with his key worker in tidying up the garden, in preparation for a summer party. Examples were seen of the detailed risk assessments recorded in care plans for all resident activities. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 9 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, 14, 16, 17 Links with the community are good, supporting and enriching the residents’ social lives and their opportunities for recreational activity. EVIDENCE: Activity programmes showed that residents access the local and wider community facilities on a daily basis. On the day of the inspection, the home’s minibus was being serviced off site. Three residents had recently visited the London Eye, another resident said that she and two of the others went horse riding each week. Five of the current residents attend college courses. The home has two vehicles and staff said that there were daily excursions, shopping trips and club outings. Residents said they enjoyed visiting the pub, the bingo hall and bowling alley. There are weekly aromatherapy and music sessions provided at the home. The manager confirmed that residents were encouraged to maintain family contacts. During the inspection one of the residents was using the ‘phone provided, to make a personal call to a relative. The residents treat the home as their own, some choosing to spend time in the communal rooms and others in the privacy of their own rooms. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 10 A satisfactory level of social interaction amongst the residents and with the staff was observed. The Inspector joined staff and residents for their light midday meal; staff were observed being attentive to the needs of residents, whilst at the same time giving encouragement to develop self-help skills. The weekly menu showed a varied diet was offered and staff said that menus were produce to called at the include residents’ ideas and choices. The Community Dietician had recently been called to the home to provide advice to staff in connection with a healthy eating programme for residents wishing to loose weight. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 11 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 good multidisciplinary working with the Community Teams on a regular basis. EVIDENCE: Key workers involve the residents in a regular review of their care planning and goal setting. The goals, agreed through this process, form an important part of the residents’ daily life-styles. It was clear that key workers give personal support and guidance wherever needed and that residents were encouraged to exercise self-determination and control over their own lives, within agreed limits e.g. when to get up, go to bed and how to spend their time. The Inspector was told that the home receives good support from the local Community Health Care services. Residents see a chiropodist every 3 months and arrangements are made for dental checks and treatment. Staff work together with the residents to promote healthy living e.g. weight watching. All staff responsible for the administration of medicines have received training from the pharmacist and some said they had also attended a college course. The dispensing pharmacist visits the home on a quarterly basis, with records of these visits recorded. None of the service users are assessed as being able to administer their own medicines. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 12 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 and their way of working proactively with residents ensured their views were listened to and acted upon. Adult protection training for all staff further supports the residents’ welfare. EVIDENCE: The minutes from the residents monthly meetings and recent (resident) questionnaires provided evidence that each resident is encouraged to express their views. Staff said that during their regular key worker sessions, the residents would confide in them if they had any concerns. The home has polices and procedures that detailed the required action to be taken, in the event of suspected abuse. It was confirmed that all staff receive training in protecting vulnerable adults and managing challenging behaviour. The manager said that the home will only offer employment to new staff, subject to satisfactory references and Criminal Records Bureau checks. An inspection of staff records bore this out. Residents are supported with the management of their financial affairs and to exercise control over their bank accounts. The manager produced the records of individual’s expenditure and income. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 13 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, 28, 30 The overall standard of the home’s premises is good, providing residents with a safe and homely place to live, which is suited to their needs. EVIDENCE: The home continues to make progress in redecorating and carrying out essential maintenance to the property. The employed maintenance man explained his role to the Inspector and pointed out the redecoration work that he has recently carried out. The standard of décor and furnishings is satisfactory in all areas of the home inspected and used by residents. The manager produced records of both weekly and monthly checks that are carried out and a maintenance book for use by all staff. The Fire Safety records showed that risk assessments are carried out and recorded on a regular basis. The regular practise fire drills are conducted for staff and service users. The records also showed that staff are receiving their required fire safety training, including night staff. During a physical inspection, the home was seen to be clean and hygienic. Residents said they were encouraged to keep their own rooms tidy. Care support workers carry out household tasks, including cooking, cleaning and laundry. Staff were seen to be wearing suitable protective gloves and aprons, when in the kitchen. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 14 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, 34, 35, 36 Staff morale is good resulting in an 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, from their varied ethnic cultures. Three staff have gained the NVQ awards and a further eight are currently working towards this qualification at level two. The attitude of staff, observed during the inspection, towards residents was attentive, calm and caring; they appeared to be experienced and competent in their work. Staff files inspected showed that appropriate procedures are adhered to, including satisfactory references and Police checks being a requirement before the commencement of a successful applicant’s employment. The manager is a qualified NVQ assessor and has also trained as a trainer in the subject of adult abuse. A detailed staff training programme shows that a variety of external courses are accessed by staff. Individual training plans are followed by all staff and recorded in their personnel files. The staff spoken with said that they felt well supported by their manager; records are kept by the deputy manager of regular staff supervisions and monthly staff meetings. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 15 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 home provides sound management and effective organisational support, which ensures the safety and wellbeing of residents. EVIDENCE: The manager is suitably experienced, after five years in this post, and demonstrates a good role model for senior staff and support workers. Staff appear well motivated and cheerful in their work and the home can clearly be seen as running smoothly. The home has a good record of reporting any notifiable incidents to the appropriate Authorities, including CSCI. The manager is already part qualified in care management and is undertaking a foundation degree in Health and Social Care. She has developed commendable quality assurance and monitoring systems, having devised separate satisfaction survey questionnaires for residents, relatives, staff, professionals and other visitors to the home, which were shown to the Inspector. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 16 The records of regular health and safety and fire safety checks being carried out were detailed and thorough. The manager said that safe working practices were adhered to in all areas of the home’s provision and the records showed that staff received regular training input, to that end. Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 17 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 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashgrange House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 4 x x 3 x H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 18 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. Standard 06 Regulation 15(1 & 2) Requirement That all service users individual care planning documents are regularly monitored to ensure these are satisfactorily completed and maintained by the support staff responsible. Timescale for action On-going 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 Good Practice Recommendations Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 19 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 Ashgrange House H59-H10 S21430 Ashgrange House V234679 120705 Stage 4.doc Version 1.30 Page 20 - 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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