Inspection on 17/06/08 for Ashington House

This inspection was carried out on 17th June 2008.

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

Ashington House 05/06/07

Ashington House 17/05/06

Ashington House 16/11/05

Ashington House 03/05/05

Ashington House 22/09/04

Ashington House 29/04/04

Ashington House 06/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Ashington House 402 Malden Road Worcester Park Surrey KT4 7NJ Lead Inspector David Halliwell Unannounced Inspection 17th June 2008 09:30 Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 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 Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 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. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashington House Address 402 Malden Road Worcester Park Surrey KT4 7NJ 020 8330 7476 020 8330 7476 AshingtonHouse@aol.com 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) Ashington House Limited Manager post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The handbasin in one bedroom may be removed, to be reviewed at least annually. 5th June 2007 Date of last inspection Brief Description of the Service: Ashington House is owned and managed by Allied Care, a private organisation. It is a large semi-detached property on the main road from New Malden to Worcester Park. It is situated close to local amenities and is a short distance from a large local park. The home offers accommodation to adults who have a learning disability, with challenging behaviour. The service aims to provide six permanent placements in time. At the time of the inspection there were two permanent service users residing at the house. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The stars quality rating for this service is good. This means that people who use these services experience good quality outcomes. Service users said that they like to be called residents. This was an unannounced inspection visit of the service at Ashington House. The Inspection covered all the key standards and involved a tour of the home, a review of all the homes records and formal interviews with 1 member of staff and the Manager and 2 of the 4 residents. A completed AQAA was received prior to the inspection. No enforcement activity has occurred since the last inspection. There have not been any changes in the ownership or management of Ashington House, Allied Care remain the provider agency. The Manager is due to be registered with the Commission for Social Care Inspection as the Manager by the end of July 2008. No requirements have been made as a result of this inspection. 1 good practice recommendation has however been made. Feedback on the recommendations was fully explained to the Manager at the end of the inspection visit. We found the residents and staff most helpful and they are to be thanked for the assistance that they gave him over the course of this inspection visit. We were impressed by the commitment and enthusiasm of the Manager and of the staff group and of the quality of the services being provided at Ashington House. The Manager told us that the cost of a placement at Ashington House ranges from £1300 to £2500 per week for 2:1 staffing levels. What the service does well: The home is taking all of the necessary action to ensure that the residents are well cared for, have their health and social care needs assessed and provided with the support that they require. The residents are actively encouraged to make informed choices and they are supported in order to help them maximise their full potential. They are able to make choices in many aspects of their daily living including with their preferred activities. Residents are treated with the appropriate degree of dignity and respect and are clearly happy living in this their home. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 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 Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective service users may be fully assured that their needs are assessed and that their individual aspirations and wishes will be taken into account in the assessment process. EVIDENCE: Standard 2 – As a part of this inspection we reviewed 2 of the 3 resident’s files. Since the last full key standards inspection 1 new resident has been admitted and his file was one of those reviewed. A full needs assessment from the referring agencies was seen on the files inspected. These needs assessments cover all aspects of the persons life and include their cultural and faith needs. The care staff within Ashington draw up their own needs assessment, together with the resident and their families and this is also based upon the assessment information provided by the referring agency. The care plans are clearly based on all the needs assessments referred to above. In both of the residents files inspected their care plans were seen to be comprehensive in the detail. The plans include the wishes and preferences of Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 9 the residents and the process of care planning was sent to be inclusive, in that all the key people are involved in their composition and review. The home also provides residents and their representatives with the information they need to make an informed choice about where to live. The needs assessment and care planning process should assure prospective residents that their needs would be met. There are three residents living in the home at present. Residents are provided with an individual contract and statement of the terms and conditions within the home, appropriately completed copies of which were seen on the 2 files inspected. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, & 9 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents may be assured that their assessed and changing needs and personal goals will be reflected in their care plans. They may also be assured that they will be able to make decisions about their daily lives and be enabled to take risks as part of developing a more independent lifestyle with support, as they need it. EVIDENCE: Standard 6 - Residents have a Lifestyle Plan that follows the Person Centred Plan approach and makes them the central focus of the planning. These plans are very comprehensive and include detailed information on the resident’s needs and personal goals. The plans were seen by us to be reviewed every at least once every six months. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 11 The Manager said that resident’s risk assessments have been completed with the support of Kingston’s Psychology Department at the Rose Lands Clinic. The Manager said that in the section of the resident’s lifestyle plans entitled “My Safety and My Security” is where risks are identified and strategies evaluated. Two of the three resident’s files were inspected and all the appropriate documents required in regulations were held on these files. It was also evidenced that appropriate risk assessments had been completed for residents covering all aspects of potential risks to them. Standard 7 – We found evidence to suggest that residents are enabled wherever possible to make decisions about their own lives. Choices were seen by us to be offered to the residents to do with many aspects of their daily lives including choice of menu, activities, holidays, what to wear, when to get up and when to see their friends or families. This was also supported by evidence seen in the residents file review and by staff interviewed by us. Standard 9 - Risk assessments have been completed and were seen to be held on file for the residents. These risk assessments are part of the resident’s plan; they have been agreed with the relevant professionals and the residents where possible. The risk assessments seen by us at this inspection detail actions which must be taken in order to minimise potential risks and hazards for residents and yet support them to be as independent as possible. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users may be assured that wherever possible they will be able to take part in appropriate activities, some of which will be based in the local community. That they will be supported to maintain appropriate personal relationships with family and friends; and that their rights will be respected and their responsibilities recognised in helping them to construct an appropriate programme of activities in their daily lives. Residents were seen to be offered a healthy, nutritious and varied diet according to their needs. EVIDENCE: Standard 12 – The Manager told us that in order to ensure that each resident is involved in daily activities appropriate to their needs and wishes, staff Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 13 maintain daily activities sheets. These record the activities of each resident and link the activities with their care plan objectives and what they say they want to do. Inspection of the resident’s files showed that the resident’s care plan objectives do identify activities that are appropriate to the resident’s age and cultural needs. Residents interviewed said that they participate in the activities they wish to do. Residents told us that if they wanted to do an activity, staff would support them to do so. The Manager told us that as a part of trying to maintain continuity for the residents in their daily lives and to support their rehabilitation, where ever possible previous interests, pastimes, hobbies and relationship are encouraged and are built into the daily activities plan for residents. 1 resident who spoke to us said, “I have a fuller life here than where I lived before”. We also spoke to this resident’s parents and they confirmed this for us. Visitors are made welcome when they come to the home. Information about local activities was seen on the notice boards within the home and staff who were interviewed by us said how they will support residents, in their capacity as care support workers, to take as much of an active role in the community as is appropriate for residents. Residents were seen to be supported and enabled to take part in appropriate activities and that they are able to express their wishes and be listened to and responded to with active and appropriate support. Standard 13 –Ashington House actively encourages residents to develop and maintain social, emotional and independent living skills wherever possible as a part of their care package. Staff were seen to be actively supporting residents to make informed choices about the things they want to do and the activities they need to do. The Manager informed us that all residents are registered to vote and are encouraged to use their votes. Residents confirmed that they are supported and enabled to vote. The Manager said that relations with the local neighbours are good with no problems arising up to this point in time for the home or for the neighbours. From information seen in the care plans and from discussions held with staff and residents, they do seem to be engaged as much as is possible with their local community. Standard 15 – An interview with each of two of the residents confirmed that where possible they do maintain regular contact with members of their families and on the day of this inspection one of the resident’s parents were spending Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 14 the day with them. Residents said that they enjoy the opportunities that they experience at Ashington House. Staff interviewed by us said that they encourage these visits and are sometimes involved in helping their resident’s sort out difficulties that they experience their relationships with their relatives as this often has a direct bearing on the mental well being of the resident. Visitors to the home are encouraged and use the visitor’s book to sign in. We saw information made available within the home about local activities for residents to take up if they wish. Standard 16 - Policies were seen to be established within the unit that ensure a service user’s rights to privacy, respect and dignity are respected. Both residents who were interviewed also confirmed that they felt staff respected these rights. Residents said that staff use their preferred form of address and that staff do knock on their doors before entering. We observed staff to be interacting with residents in a friendly and respectful manner and staff confirmed in interview that they understand how to respect the privacy and dignity needs of the residents. There are not any smokers at present living at Ashington House. There are appropriate policies regarding drug and alcohol taking on the premises. Standard 17 - With regards to meals and meal times there is a planned and varied menu which residents told the Inspector they enjoyed. We saw suitably planned menus for 3 weeks ahead. Specific needs are catered for and a visiting dietician is fully involved given the diabetic needs of one resident and the need for a weight reducing diet for another. A record is kept by staff of all the food residents consume and this is seen to be a useful tool that helps staff ensure that residents have an appropriately healthy and varied diet. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19, & 20 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users may be assured that they will receive personal support in the way they prefer and require, they may also be assured that their physical and healthcare needs will be appropriately met. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Standard 18 - The residents at Ashington House are able to express their wishes and preferences with regards to the support they receive with their personal care. At this inspection we saw several ways in which this is achieved. Residents were seen to have a central role in informing their Lifestyle plans. These plans include the wishes and preferences of the residents which are outlined in detail alongside the care plan objectives. Lifestyle plans were seen by us on each of the residents file’s inspected. The Manager said that each resident has their own key worker and those Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 16 residents regularly discuss with their key worker their needs and wishes for personal support. 2 residents interviewed by the Inspector were able to confirm this and said that they find the key worker system helpful. In addition to this residents are able to discuss their needs and wishes with other staff as and when appropriate. Regular “in house” meetings are held and minutes of these were seen at this inspection. These meetings have been well attended by the residents who have discussed a variety of issues important to them, such as holidays and outings, the menu planning and other in house issues about which they have been able to express their wishes and preferences and make decisions. Residents told us that they are able to choose when they get up and when they go to bed, what they wear, when they have a bath and what activities they want to do during the day. We saw this in practice over the day of the inspection where residents were actively engaging in this way with staff. There was also clear evidence of the residents having access to other key professionals who are able to support their needs and with whom they have a participative relationship. The Manager told us that professionals such as nurses and care managers provide regular input to the care of the residents. Evidence of this was seen on the daily notes and care plan reviews held on the resident’s files. Residents family’s wishes for the service users upon death and dying are now recorded in the service user Lifestyle plan files. Standard 19 - The Manager informed us that the healthcare needs of residents are assessed and reviewed regularly as a part of the care planning process. This was supported by evidence on resident’s files. All residents do have access to the full range of healthcare professionals thereby ensuring that their needs are being met. Resident’s health checks are usually undertaken by the GP within the home. Standard 20 - We reviewed the medication records (MAR sheets) together with a senior member of the staff group and no errors were found. 2 members of staff have daily responsibility for supervising medication administration for the residents who have been assessed as being unable to administer their own medication. The Manager informed us that staff have all been involved in discussions about the importance of following the policy on the administration of medication within the home and have received appropriate training on administering medication. A stock take check of the medications held in the home showed that the medication records do accurately reflect the current medication stocks. An appropriate locked metal cupboard is provided for the resident’s medications. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users may be assured that their views will be listened to and that they will be protected from abuse, neglect and self-harm. EVIDENCE: Standard 22 – During the course of this inspection we spoke to two residents. Both confirmed that they feel their views are listened to and acted upon. A copy of the complaints procedure is made available in the Statement of Purpose and in the Service User Guide so that residents, families and other representatives know the procedure to be followed and would be able to do so if required. Staff interviewed confirmed their awareness of the complaints process and the Manager confirmed that the whole staff group take any issues raised by residents seriously. We looked at the complaints procedure for the home and can confirm that the procedure is properly constructed and includes all the necessary elements such as timescales and who to contact, including the CSCI with all the appropriate contact details. The complaints record was reviewed by us and no complaints had been made since the last inspection visit. Standard 23 - The home has an adult protection policy and the Manager said that all the staff group have received appropriate training in June. This was Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 18 supported by documentary evidence seen by us. It was also confirmed by a member of staff interviewed and this means that resident’s should be protected from abuse, neglect and self-harm. We inspected the allegation of abuse record and none had been made since the last inspection. The Manager was also able to confirm this. The Manager informed us that the home does look after resident’s monies and explained that there is a record of all transactions which is signed by the resident and staff at the time of the transaction. All monies are stored securely. The Manager also explained that she does a monthly audit of these finances. Appropriate records supporting this were seen by us at this inspection, with no concerns being raised. The policies and procedures manual for the home includes a whistle blowing policy and a policy on dealing with violence and aggression. Understanding the policies and procedures is a part of the staff induction process and staff are now asked to sign to say that they have read and understood the policies and procedures. This should help to ensure that staff are aware of and are operating within the unit’s policies and procedures. An inventory of resident’s belongings is taken when they come to live at the home and this continues to be maintained and kept up to date by key workers for all residents’ valuable belongings that are kept in their bedrooms. The Inspector checked these records. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users at Ashington House are able to live in a homely, comfortable and safe environment. The home is also clean and hygienic and well looked after by staff. EVIDENCE: Standard 24 – The Manager explained that the home does offer planned respite / short term care for a specified period to the same person every year. He has his own bedroom but otherwise shares the other facilities in the home. Other residents are said to be quite happy with these arrangements. Over this inspection, we saw all the rooms in the home in order to check that it provides a safe and well-maintained environment for its residents. The standard of décor was seen to be good, it is clean and bright and residents are Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 20 able to choose the colours and decoration for each of their bedrooms. Residents were seen to have their personal possessions arranged as they wish in their bedrooms. The communal areas such as the dining room and the lounge, bathrooms and toilets are also in a good state of decoration and the overall impression provided is one of a well maintained and clean home. There are 3 bathrooms / toilets for the unit, 1 of which is ensuite and is wheelchair accessible. The garden is accessible to the residents and is well kept and has a pleasant well-maintained feel. The Manager told us that two days a week have now been allocated for the handyman at Ashington House and that this has made a huge difference in that repairs are now being addressed before work required to be done becomes a hazard. The last check on the unit’s fire equipment found everything to be satisfactory, Fire and Security Ltd undertook this on 12th June 2008. Emergency alarm systems were all checked at the same time including the fire alarm, automatic door releases and the nurse call cords and all were found to be satisfactory. A check on water temperatures found both hot and cold water to be within the recommended temperature levels. The unit’s fridge that was found to be faulty at the last inspection has been replaced. A satisfactory test was carried out on the unit’s water storage facilities for legionnaires disease on 15th January 2008. Standard 30 – We were shown by the Manager the home’s policy and procedures on infection control. This contains all the relevant information and legislation on infection control and should provide good guidance for the staff in ensuring high standards are maintained in the home. The Manager also told us that training is provided to staff on a regular basis and that infection control forms part of the induction training for all new staff. The laundry floor was seen to be impermeable and the walls and floors are readily cleanable. Staff told us that they are provided with appropriate equipment to do the job. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 & 36 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from the clarity of staffing roles and responsibilities and they can be assured that they are supported by competent, appropriately trained, qualified and supervised staff. The homes recruitment policy and procedures helps protect the residents. EVIDENCE: Standard 32 – We saw staff working with residents at Ashington House to be approachable and to take time to deal with their questions appropriately and patiently. The Manager said that there is a training programme for staff provided both in house by staff and also external agency training. This covers all the essential training required by the staff to do their jobs well and efficiently. The provision of funding for training is also said to be good and the Manager told us that if a training need is identified then a training course could be provided. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 22 The Manager informed us that all the support worker staff have achieved their NVQ level 2 awards and 2 are now enrolled to undertake their NVQ level 3 awards. Documentary evidence of this was seen on staffing files. We gained the impression over the course of this inspection that all the staff are committed to ensuring that their skills and knowledge is continually being developed by appropriate levels of training so that they can best meet the needs of the residents. Training records were examined and evidence was seen that evidenced staff had completing the following training courses: • 1st aid • Food hygene • POVA • Health & safety • Infection control • Equal opportunity • Medication Standard 34 - The Manager told us that the home does have a recruitment policy and procedure and that all staffing posts are filled by application and interview. Evidence of these processes being used were seen on the staffing files. The Manager said that she, the Deputy and the Area Manager usually constitute the interview panel. The Manager said that 1 new member of staff had joined Ashington House since the last inspection. Review of 4 of the staffing files, including the file of that new staff member, evidenced that suitable application forms are completed, that 2 references are obtained including one from the last employer. All staff files reviewed evidenced that proper CRB checks have been carried out for staff employed within this unit. The Manager told us that in all cases enhanced criminal record bureau (CRB) checks are carried out by the agency for all new staff. Documentary evidence was made available at this inspection. This information certifies that the appropriate checks have been completed however in some cases these checks had been carried out in 2003 and 2005. It is good practice to renew all staff CRBs every 3 years. The Manager told us that CRB renewals for all staff has been planned for 2008. All other documentary evidence required (under Standard 34) for staff was seen to be held on the staff files reviewed. The result of this is that there is at Ashington House a staff team that has a balance of the skills, knowledge and experience to meet the needs of the residents. Staff interviewed confirmed that all have a contract of employment and that they understand their terms and conditions as well as their roles and responsibilities within the home. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 23 Standard 35 – As already indicated earlier in this report the Manager has said that there is an overall training and development plan and budget for the home. The Manager said that a structured induction programme is offered to new staff and documentary evidence of this was seen and supported in interview with staff. It includes: • Safe working practices • The workers role • Meeting the needs of service users • The home’s policies and procedures. The Manager does need to ensure that as staff complete their induction they sign and date their programme notes. The Manager said that she has introduced a new staff training matrix that identifies future staff training needs and that logs training already undertaken by staff. This is a useful tool in that it will easily inform the Manager what training the staff team have received and where the gaps in training exist. Standard 36 – The Manager told us that there is a properly structured staff supervision policy and procedure. Records were inspected and both the policy and the supervision tools comprehensively cover the areas that are required in order to implement an effective supervision process. Inspection of the supervision records that are held on staffing files showed that staff have received fairly regular and formal supervision. Areas of discussion included: • Resident’s issues • The key working process • Monthly reports on progress made by key workers with care plans • Daily activities and outings for residents • Employment and training needs • Holidays and leave • Work performance issues. This means that all the key and important areas for the review and monitoring of the work being done in the home to meet the needs of both the residents and the staff groups should be properly met. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 & 42 were inspected at this inspection. People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they benefit from a well run home. The quality assurance system helps to ensure that their views underpin monitoring and review of the homes developments. Service users may also be confident that their rights and best interests are safeguarded by the home’s record keeping policies and procedures. EVIDENCE: Standard 37 - A requirement was set at previous inspections that the organisation must appoint a manager to run the home and the Manager must Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 25 be registered with Commission for Social Care Inspection. The Manager informed us that she completed her Registered Managers Award in January 2008 and thereafter submitted her application. She said she is now waiting confirmation of her registration from the Commission. The Manager showed the Inspector her job description, which does support her in her duties. Standard 38 – The Manager told us that the home does have regular meetings for staff and residents approximately every 3 months. Minutes of these meetings were seen at this inspection. Appropriate agendas were seen to be discussed and the meetings were seen to be well attended. The Manager explained that the daily handover meetings are also used to report incidents and feedback about visits and other daily events. Advocates are encouraged to attend the residents meetings in order to support the residents and ensure their voices and opinions are heard. The two residents interviewed told us that they found these meetings useful, they said, “We can discuss things that we want to be sorted out” and “I like these meetings, we get to talk through things”. Standard 39 - During this inspection we asked the Manager about the quality assurance process being used within the home and how this had been progressed over the year since the last inspection. This is important at it helps to assure residents and their representatives that their views underpin all service improvements and developments made by the home. At the time of this inspection the Quality Assurance Auditor was also present. The Manager informed us that a feedback questionnaire was provided to the residents and their relatives as well as to visiting professionals in March 2008. The questionnaires were inspected and seen to seek the views of these people about the services being offered by Ashington House. It is recommended that this information be analysed by the management team to build on and improve these services. It would be useful if this information were included in the business and annual development plan for the home. Standard 42 - Policies were seen by us for Health and Safety; fire; moving and handling and risk assessment relevant to the unit. The Manager informed us that all staff have been asked to read these policies and procedures and sign to say that they have read, understood and are prepared to work within them. Most of the staff have received training in moving and handling; fire safety; first aid; food hygiene and infection control. The Manager should ensure that all staff have undertaken recent training in these areas. Food temperatures are taken and recorded for every meal. Appropriate records were seen by us as were the records for fridge and freezer temperatures that Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 26 were seen to have been tested daily and maintained within the acceptable ranges. Hot water temperatures are being regularly tested and records seen by us confirm that temperatures have all been within the accepted ranges. Up to date certificates were seen for the appropriate checks and requirements within Standard 42 of “safe working practices” • Boiler – 17.6.08 • Fire alarms and all fire prevention systems and equipment – 12.6.08 • Emergency lighting tested – 12.6.08 • Portable electric appliances – 5.4.08 • Legionella water test – 15.1.08 • A general buildings health and safety check is undertaken by the Manager regularly and a record of these checks was seen for May 2008. Weekly fire alarm tests are being carried out and these checks are recorded on paper appropriately. The home has self-monitoring systems in place such as internal audits and regulation 26 visits. The Manager told us that all incidents and accidents are recorded in a record book. We saw evidence of this. Incident and accident forms are used; the last was recorded in March 2008 and was satisfactorily dealt with. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 27 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No. 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 YA39 Good Practice Recommendations Feedback information provided as a part of the quality assurance audit should be analysed by the management team to build on and improve services. It would be useful if this information were included in the business and annual development plan for the home. Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ashington House DS0000013378.V365690.R01.S.doc Version 5.2 Page 30 - 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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