Inspection on 16/08/05 for Ashlea Hostel

This inspection was carried out on 16th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashlea Hostel 23/05/07

Ashlea Hostel 31/05/06

Ashlea Hostel 06/01/06

Ashlea Hostel 08/11/04

Ashlea Hostel 13/04/04

Ashlea Hostel 05/06/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Ashlea Hostel 53 Coronation Avenue Alvaston Derby DE24 0LR Lead Inspector Jo Wright Unannounced 16 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashlea Hostel Address 53 Coronation Avenue Alvaston Derby DE24 0LR 01332 718105 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) Derby City Council Vacant Care Home 22 Category(ies) of Adults aged between 18 and 65 years with registration, with number Learning Disabilities (22) of places Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th November 2004 Brief Description of the Service: Ashlea is a 22 bedded care home for adults aged between 18 and 65 years old with learning difficulties. The home provides short term and respite care, and accepts emergency placements for up to eight weeks. Ashlea has gardens to the front and rear of the building and is located in a residential suburb of Derby. Accommodation for service users is located over two floors. Lounge and dining facilities are located on the ground floor only. Access to the first floor is via stairs. Ashlea is located close to main bus routes in the city centre. Ashlea has well established links with the community in which it is situated and service users regularly use the local amenities. There are also good links with day services, which are used throughout the week by service users. Transport to and for the day centres is either arranged through community transport or by taxi. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out over 7 and a half hours. The majority of the seven service users currently accommodated at the home were attending day services during the inspection, although four service users were spoken with prior to them leaving the home in the morning, as well as the one service user who remained at the home all day. The records and care needs of two service users, along with medication and personal allowances were looked at. What the service does well: What has improved since the last inspection? What they could do better: Staff need to be provided with up to date and accurate information about peoples needs prior to them being accommodated at the home. Care planning needs to improve so that staff know what to do for each person. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 6 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 Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 Insufficient information was available to enable service users/carers to make an informed decision about staying at the home and to ensure that staff could fully meet individual needs on admission. EVIDENCE: Systems were not in place for organising service users files and obtaining the required information about people. The admission procedure did not always provide staff with current and up to date information from care management about individual service users. A care management assessment and care plan was available in the file for one service user admitted to the home as an emergency during July 2005. However, this assessment and care plan was dated November 2004 and related to an admission to a previous care home. There was no evidence to support that the information provided had been reviewed and was still current and up to date. An up to date assessment and care plan was not available for the service user admitted for respite care. Care plans had not been developed by staff in the home for either service user. Individual service user contacts were not available in the files. This has been outstanding in the previous three inspection reports. A copy of the proposed Service User Guide was provided. This document was set out in a format suitable for the service user group. However, all of the information as outlined in Standard 1 was not included in this document. Copies of the Service User Guide have not been provided to service users. This has been outstanding in the previous three inspection reports. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, and 8 Staff and advocacy services supported people to participate in making decisions about their lives. However, there was no clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: Individual care plans developed by staff were not available for all service users. Efforts were being made to develop these plans, but neither file examined contained these. Discussion with staff suggested that service users needs were met because staff had a good knowledge of the service users who regularly use the respite service, even though care plans were not in place. This approach is dependent on staff memory, good verbal systems and continuity of staffing, and places people using the service at risk of not having their needs met if these informal systems break down. Information recorded in the daily logs supported that service users were making decisions about their lives. Several service users spoke about where they wished to move to when they moved on from the home and the records supported that a number of options had been explored with the service user. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 10 Service users were supported individually and collectively by advocacy services, and were able to discuss any issues or changes during the monthly meetings. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 16 and 17 People living at the home were supported to develop as individuals and to join in with appropriate activities. Friendships and family contacts were encouraged and maintained as appropriate. Links with the community were good and support and enrich service users’ social and educational opportunities. EVIDENCE: The facilities provided at Ashlea limit the opportunities for personal development. However, staff and service users make use of the domestic style kitchen for activities such as baking. Staff provide support and assistance to people to enable them to move into the community after their stay at Ashlea. The majority of service users who use the facilities at Ashlea attend day centres. One service user indicated that they worked on reception whilst at the day centre, as well as helping with the gardening. Service users were encouraged to attend activities outside of the home, either with families or accompanied by staff. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 12 Good use was made of the facilities in the local community. Either staff from the home or community support workers assist service users to access community facilities, although a number of service users go out independently. People living in the home were able to take part in planned activities both inside and outside the home, and this information was recorded in daily logs. The records also supported that the choice not to join in with activities was respected by staff. There were no visitors present at the time of this inspection. However, visitors were welcome at any time and staff support service users to maintain contact as appropriate. One service user discussed plans to meet their friend in the city centre the day after the inspection. The majority of service users who use Ashlea do so for respite/short term care and return to their community on discharge. Routines within the home were kept to a minimum, although the routines of the day centres services influenced routines during the week. Service users talked about having a ‘lie in’ at the weekends. People made good use of all areas of the home. Service users interacted well with each other and with staff. Service users spoken with who were receiving respite care indicated that they liked their short stays at Ashlea. Those service users on longer placements talked about their future plans and where they wished to live following Ashlea or that they would be returning to their home in the community. Meals were discussed at the service user meeting held in July 2005 and the minutes indicated that generally people were happy with the meals provided. The main kitchen has recently been refurbished and the domestic style kitchen was used during this time. The menus were altered to accommodate this change. The cook indicated that the menus were currently under review, following the refurbishment of the kitchen. Catering staff had a good knowledge of service users needs and information about each service user was available for reference. A choice of meal was always provided, and supported through records. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 13 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) 19 and 20 Service users health care needs were met with support and assistance from staff. Inconsistent staff practice around recording of information on medication records potentially placed service users at risk. EVIDENCE: Records confirmed that staff support service users to attend health care appointments. Staff were observed arranging an emergency dental appointment for one service user, and accompanying that person to the appointment. Information provided by health care professionals was available in service users files. Medication policies and procedures specific to Ashlea were in place, and related to the service provided at the home and the challenges relating to medication that this presents. All staff responsible for administration of medication receive general training from the local pharmacist, and training specific to the systems in place at Ashlea from a manager. Staff were supervised until they were assessed as competent and confident to administer medication. The medication records supported that service users had been given medication as prescribed. However, details of the GP, any allergies and start date were not always recorded on the hand written medication records, and two members of staff had not always signed these records. The system for recording receipt of medication was used inconsistently. Staff indicated that the medication Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 14 refrigerator was on order, and due to be delivered in the near future. There was no medication requiring cold storage at the time of this inspection. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 15 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) These standards were not assessed during this inspection. EVIDENCE: Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The environment was clean, tidy and comfortable. EVIDENCE: Ashlea only accommodates service users for short term care and emergency admissions for up to eight weeks. Service users requiring longer term care move on to alternative accommodation following their stay at the home. Ongoing efforts to improve the environment were evident. New flooring was being laid in two bedrooms used predominately for service users with a high level of physical needs. Decoration throughout the building was ongoing. Alterations to the building and provision of new furniture have created a more domestic appearance in the communal areas. A number of doorways have been widened and ramped access provided on external exits. A loop system to assist service users with hearing impairment was being fitted on the day of this inspection. The home was clean and tidy at the time of this inspection. The separate laundry area was well organised and clean. Laundry equipment was in good working order. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 17 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 Service users appeared to be supported by competent and qualified staff. EVIDENCE: Staff spoken with confirmed that they were offered a range of training opportunities, including adult protection, SCIP UK training and fresher training, the mandatory training (except infection control), and training towards National Vocational Qualifications. Staff indicated that newly appointed staff completed the specified induction programme. Training records were not checked during this inspection and will be reviewed at the next inspection. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 This home is well managed although improvements in some areas of recording are required to support this and ensure service users needs are met and their views and wished recorded. EVIDENCE: The current manager has been in post for a number of months and has submitted an application for registration with the Commission. The manager and staff team were well supported by the service manager, who visits the home unannounced on a regular basis. Staff indicated that the service manager speaks with service users and staff during these visits, as well as reviewing records. However, the outcome of these visits was not formalised into a written report, although verbal feedback was given. This has been a requirement in the previous two inspection reports. Staff reported that they do not receive training on infection control. Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 19 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 2 2 x x 1 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashlea Hostel Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 20 Yes 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 1 Regulation 5(1) Timescale for action The Serivce User Guide must be 30 further developed, to ensure that November it contains all of the information 2005 as outlined in Standard 1 and Regulation 5. The Registered Person must 30 provide each service user with a November copy of the completed Service 2005 User Guide (Previous timescale of June 2004 not met) The Registered Person must 30 ensure that all service users November have their needs assessed and 2005 this information is available in the files of individual service users. This assessment must take place prior to or on admission (Previous timescale of 31 July 2004 not met) The Registered Person must 30 ensure that plans of care for all November service users are developed from 2005 the assessment of need, which set out in detail the action that needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met (Previous timescale of 31 July 2004 not met). The Registered Person must 30 Version 1.30 Page 21 Requirement 2. 1 5(2) 3. 2 14(1)(a) & (b) 4. 2 5(1)(a) 5. 2 17(1) Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc 6. 5 5(1)(b) & (c) 7. 6 15(1) 8. 20 13(2) 17(1)(a) Schedule 3 13(2) 17(1)(a) Schedule 3 26 9. 20 10. 37 11. 42 18(1)(a) & (c) ensure that all information outlined in Scheudle 3 of the Care Homes Regulations 2001 is maintained and available in all service user files (Previous timescale of 31 January 2005 not met). The Registered Person must develop and agree with each service user a written and costed contract/statement to terms and conditions between the home and the service user (Previous timescale of 31 July 2004 not met). Whenever possible, service users must be involved in drawing up agreeing their care plans, and if impractical their representative. The records must demonstrate that the service user has been involved (Previous timescale of 31 July 2004 not met). A record of all medication received into the home must be made. This includes medications that are handwritten onto the MAR chart. If medication charts are handwritten, the date for which the chart is valid must be recorded. The Registered Person must provide writtten evidence to support that Regulation 26 visits are being carried out and provide the local office of the Commission with a copy of the monthly report. These reports must be available for inspection (Previous timescale of 31 May 2004 not met). The Registered Person must provide staff with training on infection control (Previous timescale of 31 March 2005 not met) November 2005 30 November 2005 30 November 2005 30 September 2005 30 September 2005 30 September 2005 31 December 2005 Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 22 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 20 Good Practice Recommendations If the MAR chart is handwritten or altered by a member of staff this should be signed and dated by them. This should then be checked, signed and dated by a second member of staff. Details of any allergies and GP should be recorded on medication charts. 2. 20 Ashlea Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Cardinal Square Nottingham Road Derby DE1 3QT 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 Hostel C02 C52 S36149 AshleaHostel V239596 160805 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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