Inspection on 14/02/06 for Ashlee Lodge

This inspection was carried out on 14th February 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashlee Lodge 21/11/06

Ashlee Lodge 09/08/05

Ashlee Lodge 03/02/05

Ashlee Lodge 03/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ashlee Lodge 5 Jameson Road Bexhill on Sea East Sussex TN40 1EG Lead Inspector Mike Flint Announced Inspection 14th February 2006 10:00 Ashlee Lodge DS0000061465.V273441.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 Ashlee Lodge DS0000061465.V273441.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. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashlee Lodge Address 5 Jameson Road Bexhill on Sea East Sussex TN40 1EG 01424 220771 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) Ashlee Lodge Limited Lindsey-Anne Baker Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated may not exceed five (5). That the category of registration be learning disability with challenging behaviour, not falling within any other category. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. 9th August 2005 Date of last inspection Brief Description of the Service: Ashlee Lodge is a large detached Victorian house, providing residential and social care for adults with a learning disability and potentially challenging, or self-injurious behaviours. The home was re-registered in June 2004 under the ownership of the parent company, Allied Care Limited, which owns a large number of similar care homes, in the Southeast region. The home is registered for five people. Residents private rooms are on the first and second floors. There are sufficient communal spaces, including a spacious lounge, dining room a sensory room and bathroom facilities on each floor. The home is located in a quiet residential area of Bexhill-on-Sea, within easy walking distance from the shops and seafront. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over 4 hours during day in February when there were five residents being accommodated, all of who are female. Two of the residents were spoken with, as were four members of staff and registered manager who assisted throughout the inspection. Three of the residents share the same Social Services care and assessment officer from whom the Inspector received positive comments about the home’s performance. A tour was made of the premises and samples of policies, procedures and records including two care plans were inspected. The manager had sent out the Inspector’s comments cards to relatives, together with covering letter inviting a response prior to the inspection; it was disappointing to note that none had been returned. What the service does well: What has improved since the last inspection? The manager ensures that the home continues to be well maintained; all communal areas and a resident’s private room have been recently redecorated and some new bedroom flooring laid. New lounge furniture has been purchased. A commendable standard of record keeping in the home has been attained, in particular the care planning documentation, being one of the main elements of the Cared4 system of recording, recently introduced into the home by the parent organisation. Quality assurance measures at Ashlee Lodge have been markedly improved upon since the home was taken over by the Allied Care organisation in June 2004; this process is continuing under the present manager. Section continued overleaf……………….. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 6 What they could do better: Suitable IT systems would enable the Quality Assurance measures to be applied and evidenced more effectively in the move towards a robust, selfregulatory status. The manager confirmed that there was further work to be done in order to complete the exercise of customizing the ‘umbrella’ policies and procedures, adopted by the parent organisation, to suit the circumstances at Ashlee Lodge. The roadside café style dining room furniture continues to create a poor impression; research into the availability of a more suitable style of furnishing to replace the existing, is again recommended. N.B. The reader should note that the text within this report remains similar to that shown in the report of last inspection and were there has been no additional evidence recorded. The reader should also be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Ashlee Lodge will be referred to as ‘residents’. The home currently meets, or exceeds all of those Standards inspected. There were no requirements made, following this inspection and only a small number of recommendations. 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. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4, 5 People who are referred to the home are fully assessed enabling decisions to be taken in respect of the home’s ability to meet individual resident’s needs. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been comprehensively revised and brought up to date. The manager said that the guide for residents is next to be produced using symbols, as an aid to better understanding by those for whom the document is intended. The records inspected showed that thorough pre-admission assessments are carried out; considerable care is taken to ensure the compatibility of any new resident, with the existing group. All parties involved are consulted with before any decisions are taken e.g. next-of-kin and caseworkers. Psychological and social care assessments are included as part of the process, prior to admission; this usually being for a trial period, following visits to meet with other residents and staff. The residents’ care planning documents, using the Cared4 formats, which include a form of service user contract, show that individual needs are regularly reviewed and daily report sheets are completed. The standard of recoding in these documents is commendable. Where there are specific health care need, residents have received on-going support from medical consultants e.g. in the case of epilepsy. Workers from the Community Learning Disability Team provide therapeutic support and advice to the home. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 8, 9, 10 The staff have a good understanding of the residents’ support needs. This is evident from the positive relationships, apparent between staff and residents. EVIDENCE: The restricted abilities of most residents to comprehend/ communicate precludes meaningful discussion with them regarding their care needs and how these are to be met. Wherever possible, encouragement is given to indicate preferences and make choices through the use of pictograms and symbols. The manager has previously said that body language also plays an important part in staff understanding the residents’ wishes. One of the residents, only, is able to make decisions about her weekly programme, undertaking a part-time (sheltered) work placement for an hour each week. The rights of each resident are protected with their being involved in decisions concerning everyday choices e.g. what to wear, meal choices, activities and bedtimes, with staff support as needed. Daily routines are agreed in the context of the detailed risk assessments that are recorded as part of care planning. Within their capabilities, residents are encouraged to participate in the day-to-day running of the home e.g. with simple household tasks, cleaning and laundry. During handovers and at staff meetings, the introduction of any proposed changes is Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 10 discussed, in response to residents expressed, or perceived needs. The home operates a ‘keeping track’ system. Staff are trained in care planning and risk assessment. All individual risks are assessed in a continuous process that ensures unacceptable risks are avoided. This comprehensive system of risk management was well documented within each resident’s care planning documentation. All staff are informed of the home’s policy on confidentiality at the time of their induction. Staff said they would know when confidential information should be shared with their manager, with parents, or others. The Inspector suggested the home’s written policy on confidentiality should be included in the information provided within the home’s Statement of Purpose. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Residents lead a fulfilling life, where both in-house and community activities provide a source of variety and enjoyment for residents. EVIDENCE: From discussions with the manager and staff there is strong evidence to show that the individual development is the common goal. The home is to be commended for its progress in modifying challenging behaviours and achieving quality of life targets for each resident. The Inspector is in a position to confirm this from first hand observations made during various inspections carried out at this home, over the last few years. Residents have opportunities to maintain and develop their social, independent living and communication skills e.g. swimming, bowling, shopping and the use of sign language and symbols. They are also encouraged to attend the local Gateway and Saturday morning clubs. Staff support residents to become part of and participate in the local community in keeping with the individual care planning e.g. shopping, road safety and keep fit classes. Wherever possible, the home identifies and arranges enjoyable, varied and worthwhile activities on an individual basis for the residents e.g. household Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 12 tasks and simple games. The residents’ weekly activity sheets demonstrate a range of varied and stimulating activities. A ‘Towards Independence’ course at college plus some paid office work has been arranged for one of the residents, who is being prepared for a move out of residential care, into a more independent living situation. Visits to the home by family members, or friends are encouraged. Residents next-of-kin are invited to attend care plan review meetings and when there is a party being held at the home. For some residents visits home are encouraged and supported. Residents may choose to assist with simple tasks in the preparation of meals. A weekly menu plan is agreed in consultation with residents. There is always a choice at mealtimes, a record being kept of any special diets or preferences. Mealtimes are flexible e.g. breakfasts and lunches, depending on what service users have planned for the day. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20, 21 The health needs of residents are well met with evidence of good multidisciplinary working with the Community Teams on a regular basis. EVIDENCE: The Inspector continues to be impressed by the quality of care given on an individual basis; staff were observed taking particular care in providing personal support to residents in the way they prefer and require, whilst being given encouragement to maximise control over their own lives. Detailed handover meetings at change of shift ensure that continuity is maintained. Each of the staff spoken with presented as knowledgeable about the needs of the residents and committed in addressing these. Care planning reviews are well documented and ensure that resident’s changing needs are responded to in a timely fashion. The residents’ health care needs are carefully monitored; appointments being arranged for specialist advice, dental treatment, chiropody and sight tests, which take place in the community. Where a residents’ challenging behaviour creates difficulties, health checks may necessarily carried out under sedation. None of the residents have control over their own medicines. The homes policies and procedures for the administration, recording, storage and handling of medicines is satisfactory. A representative from the dispensing pharmacist visits regularly and provides training for staff. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 14 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, 23 The home has a satisfactory complaints system with some evidence that residents feel their views, or concerns are listened to and acted upon. EVIDENCE: The record of three complaints that have occurred since the last inspection was examined; each was satisfactorily recorded together with actions taken and outcome. There have also been two Adult Protection alerts, again each of which has been followed up using the correct procedures. Incidents where residents have been involved in physically challenging behaviour towards one another, or towards staff, have been recorded and the required reporting procedures followed up. All staff receive training in challenging behaviour and adult protection matters. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 15 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): 24, 25, 26, 27, 28, 29, 30 The overall standard of the environment within this home is satisfactory, providing residents with a safe and homely place to live. EVIDENCE: Ashlee Lodge has a homely and congenial atmosphere. Actions are on-going to refresh the home’s décor and replace worn out furniture, fittings and floor coverings. Since the last inspection the communal lounge and dining room have been attractively re-decorated, as has one of the residents’ private rooms. Previous comments have been made by the Inspector concerning the poor quality of furnishings in the dining room; the manager has reasoned that the lightweight, plastic chairs do less potential damage, should one be thrown by a resident, in a fit of violent behaviour. The home has a sensory room, which is frequently used for supervised therapy sessions and for calming residents, who become agitated; a tropical fish tank has been donated by one of the staff, which adds to the intended ambience of this room. The home is kept clean and hygienic by the care staff, with the supervised assistance of residents, should they so wish. The house and garden are well maintained by employed workers. Regular environmental and fire safety checks are carried out and recorded by the manager. Residents’ rooms are individually decorated and furnished to suit their tastes and needs; encouragement is given for residents to take some responsibility for the rooms. Each of the residents is fully mobile and there is no current need for specialist equipment at the home. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 16 Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 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): 31, 32, 33, 34, 35, 36 Staff morale is good resulting in an enthusiastic, well-supported workforce that works positively with residents to improve their whole quality of life. EVIDENCE: Since the last inspection there has been minimal staff turnover, this included the resignation of the deputy manager and two qualified staff. The manager confirmed that the former vacancy is being recruited for and that the others have been filled. Staff duty rotas show staffing arrangements to be satisfactory and in keeping with the needs of residents. The staff employed bring a range of qualities and experience to the home; records have shown that satisfactory recruitment procedures are followed. The attitude of staff, observed during the inspection, towards residents was attentive, calm and professional. There appeared to be good team spirit amongst those staff spoken with. The manager confirmed that six of the staff have already gained, or are working towards National Vocational Qualifications (NVQ) at levels 2, or 3 in Care; the target of 50 NVQ qualified staff will be met by the year end. Staff receive contracts and detailed terms and conditions of employment; job descriptions are provided, clarifying roles and responsibilities, including those of key workers. The home has a staff-training plan, which includes the Company’s mandatory skills training and other training to meet the National Training Organisation’s targets. Individual staff supervisions take place and there are regular staff meetings. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 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 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, 38, 39, 40, 41, 42, 43 The home’s atmosphere is relaxed and well ordered, which encourages calm behaviour amongst the residents. Measures to check regularly on the home’s performance provides valuable feedback on which the manager may act. EVIDENCE: The registered manager has completed the required training for managers of residential care homes; she is a competent manager of this specialist residential care service and provides good support for her staff group. The staff spoken with said although the work could be stressful at times, though very rewarding e.g. supporting residents in achieving their goals. Residents are as involved as possible at every stage of their care planning and review. Quality assurance processes are thorough, including a high standard of record keeping. Appropriate attention is paid to ensuring the health and safety of residents through staff training and regular review. Staff receive training in all safe working practices, applicable to their employment e.g. the management of challenging behaviour, adult protection, fire safety, food hygiene, infection control and first aid. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 19 The policies and procedures are mainly those handed down by the parent organisation; the manager is working towards a revision of any of those documents that need to be customized, as they may relate to Ashlee Lodge. As far as it is reasonable to ascertain, the Allied Care organisation appears well founded, satisfactorily resourced, including infrastructures, and is a responsible provider of specialist care services. One of the Company Directors visits the home on a very regular basis, in support of the manager and staff, whilst a senior manager monitors and records the performance of the home, monthly. Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 20 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 3 4 4 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 4 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashlee Lodge Score 4 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000061465.V273441.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes, as shown below. 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. 01 Refer to Standard YA28 Good Practice Recommendations That the availability of a more comfortable and pleasing style of dining room furniture is researched, and that the existing tables and chairs are replaced. (Outstanding from previous report) That IT systems are put in place that facilitate gains in terms of Quality Assurance and improved communications with all stakeholders in the home’s performance. That the ‘umbrella’ policies and procedures, adopted by the parent organisation, are customized, where necessary to suit the circumstances at Ashlee Lodge. 02 03 YA39 YA40 Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashlee Lodge DS0000061465.V273441.R01.S.doc Version 5.0 Page 23 - 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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