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Inspection on 24/11/05 for Ashlea Care Home

Also see our care home review for Ashlea Care Home for more information

This inspection was carried out on 24th November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well decorated and homely. Service users are helped to take part in appropriate daily activities and holidays. Encouragement is given to service users to be involved in plans for their care and in the running of the home. Staff spend a lot of time talking with service users when they are at home and encourage independence where possible.

What has improved since the last inspection?

Staff have completed the individual support plans with all service users. A complaints procedure has been prepared specifically for this home using photographs of who service users can talk to about their concerns.

What the care home could do better:

Medication is looked after by staff and given to service users when it is needed. Normally, staff take great care with this, but there has been one mistake made with giving out medication. The manager has decided that two staff should be present when medication is given, but sometimes it is needed when only one staff is on duty. There is only one staff member in the house for about ten hours over night. Staff must follow medication the policy and procedures and there must be enough staff on the premises to meet needs.

CARE HOME ADULTS 18-65 Ashlea Care Home 1 Kings Road Newark Nottingham NG24 1EW Lead Inspector Meryl Bailey Unannounced Inspection 24th November 2005 02:00p Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashlea Care Home Address 1 Kings Road Newark Nottingham NG24 1EW 01636 705206 01636 705334 h2048ashlea.1kingsroad@mencap.org.uk 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) Royal Mencap (Housing & Support Services) Jayne Ramsey Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Learning Disability (LD) (8) The maximum number of service users to be accommodated is 8 Date of last inspection 26th July 2005 Brief Description of the Service: Personal care and accommodation is provided for up to 8 adults with learning disabilities. Ash Lea is a large house located in the centre of Newark and close to shops and all community amenities. There is a large lounge and separate dining room. Service Users are accommodated in single bedrooms on ground and first floors. There are steps at the main entrance and no lift to the first floor. Paved external areas provide space for outdoor activities and seating at the rear of the property. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one afternoon. All staff were present at the commencement of the inspection as a staff meeting was taking place. All of the current seven service users arrived home from day services during the inspection. Some of the service users and staff gave their views about the care provided and other information has been taken from records. The communal areas of the home were inspected, but bedrooms were not viewed on this occasion. 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. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 9 Needs are assessed and plans to meet them are clearly set out. Service users are encouraged to make their own decisions and risks are assessed. EVIDENCE: The process of transferring information onto a new support plan format has been completed since the last inspection. Two of these support plans were examined. Individual action plans have been completed for every area of need and included signatures of the service users to show their agreement to the plan of care and support. Choices were also recorded regarding keeping a key and other rights were listed with pictorial representations to ensure service users had full opportunity to understand choices and agreements. There were risk assessments on files, which had been completed for various risks associated with individual activities. Involvement in preparing meals and going out alone were assessed and some specific to individuals included going out in a wheelchair and “seizures”. Independence was encouraged where possible, but action staff should take was clearly specified. Service users spoken with confirmed the support that was given to them in their daily lives. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 the following standard(s): 13, 16 and 17 Service users use community facilities and right s and responsibilities are respected. They are involved in meal preparation and a balanced diet is offered. EVIDENCE: Service users attended local community day services as well as some further afield. They spoke about activities there and also of using other local facilities such as the library. Rights and responsibilities were addressed in individual support plans. Also, there were pictorial rotas on the notice board for household tasks. Meals were actively planned by five of the service users, who are on the rota to assist with preparation. The menu for the week was planned at a house meeting and the likes and dislikes of all service users were taken into consideration. The current week’s menu was displayed in the kitchen and showed a balanced diet over the week. The meal being prepared was Pasta Bolognese. Service users said that they always had good food to eat. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 10 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): 19 and 20 Health needs are well monitored. Medication is organised, but revised procedures are not always followed and there is a risk of error. Further training needs to be completed. EVIDENCE: Health and emotional needs were assessed and detailed in the individual support plans. All professionals involved in meeting these needs were listed with the reasons for involvement. Weights were monitored and recorded. Medication is stored securely, though space in the cupboard is limited. Tablets were dispensed into cassette boxes by the pharmacist for ease of administering to service users by staff. There had been an error made on one occasion in that an extra morning dose had been given to one service user instead of other evening medication. Appropriate immediate action was taken and the service user suffered no ill effects of the error, which appeared to be due to a change in the type of cassette box used. The staff member had not checked the medication against the record sheet. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 11 Since the error, a new revised procedure had been put in place. This stated that two staff must check medication as it is given to service users. However, there was not always two staff on duty when medication was administered. See under standard 33 for evidence of staffing levels. Most staff were currently undertaking additional medication training. Staff at the home added regular homely remedies, such as cod liver oil capsules, to the cassette boxes. This is an appropriate way of dealing with regular supplements, but the continued use should be regularly reviewed as with prescribed medication. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Procedures are in place to deal with any complaints and protect service users from abuse. EVIDENCE: There was a clear complaints procedure specifically for complaints about the service provided at the home. This was in an accessible format using photographs of staff and Makaton symbols. It was contained in the Individual Support Plan files and it was also on the wall of the dining room. Service users spoken with knew who to speak to within the home if they had any concerns. There was a copy of the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedures. The manager was aware of the procedures and training records showed that all staff have been trained in awareness of abuse. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 the following standard(s): 30 All communal areas are kept clean and hygienic. EVIDENCE: None of the service users’ individual rooms were inspected. The dining room and lounge were clean and well maintained. The kitchen was well ordered and there was a separate laundry area. There were suitable policies and procedures in place regarding infection control and disposal of clinical waste. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 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): 32, 33, 34 and 35 Staff are trained and are supported to gain further qualifications in care. The recruitment procedure protects service users. However, current shift times do not guarantee two staff being on the premises when needed. EVIDENCE: All staff were present for a staff meeting during this inspection. The rota showed two staff present during the day and one asleep on the premises at night. Times for starting and finishing the day shift varied, so that there was not always a second staff member present when medication was administered. There must be sufficient staff to meet needs at all times and if it has been determined that two staff need to be present, when service users are awake, then they must be provided. The person sleeping in was the only staff member for approximately ten hours at night from 9 or 9.30 pm. Staff said that needs were low during the night as service users usually slept well, but some were up before day staff arrived. There was an alarm for one service user, but otherwise no alarm call system, though staff said that it was possible to hear people moving around on the landing at night. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 15 Staff showed a good understanding of individual service users’ needs and were observed interacting well. Training records demonstrated that staff had undertaken training in Epilepsy Awareness and Diabetes aswell as Food Safety, Health and Safety, Moving People and First Aid. Medication training was ongoing. Two of the staff had completed the National Vocational Qualification level 2 and 2 others had almost completed. Recruitment for two further staff was taking place and the manager was awaiting references and Criminal Records Bureau checks to be completed before they could start. Records in respect of existing staff were well organised. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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): 37 and 42 The home is run by a competent manager and health and safety are promoted in the environment. EVIDENCE: The manager is registered with the Commission and has attained the Registered Managers Award. She was also qualified to assess other staff for their National Vocational Qualifications. External doors were alarmed at night and there was a policy in place for lone working. All staff completed training in safe working as part of their induction. Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashlea Care Home Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000008621.V263089.R01.S.doc Version 5.0 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 YA20 Regulation 13(2) Requirement Ensure staff complete training and comply with the home’s policy and procedure for the handling recording and administration of medicines Ensure there are sufficient staff to meet service users’ needs at all times, particularly for the administration of medication. Timescale for action 31/01/06 2 YA33 18(1)(a) 24/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Ashlea Care Home DS0000008621.V263089.R01.S.doc Version 5.0 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. 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. 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