Inspection on 07/10/08 for Ashleigh House

This inspection was carried out on 7th October 2008.

CSCI found this care home to be providing an Good service.

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

Ashleigh House 06/09/07

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashleigh House 39 Redstone Hill Redhill Surrey RH1 4BG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Williamson     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Ashleigh House 39 Redstone Hill Redhill Surrey RH1 4BG 01737761904 Telephone number: Fax number: Email address: Provider web address: sairabh@aol.com Name of registered provider(s): Name of registered manager (if applicable) Mr Mahmad Basseer Hulkhory Type of registration: Number of places registered: Mr Mahmad Basseer Hulkhory,Mrs Saira Banoo Hulkhory care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Ashleigh House has been registered by the Commission for Social Care Inspection to provide residential care for nine young adults with learning disabilities between 18 and 65 years of age. Mr Basseer Hulkhory is the current manager and provider. The accommodation is arranged over two floors. All bedrooms are single occupancy, and, with one exception, all have en-suite toilet facilities, wash hand basins and either bath or shower facilities. There is no passenger lift to the 2nd floor. There is a seperate ramped access at the front. There is a choice of communal space, and it is spacious. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 9 Brief description of the care home There is car parking space at the front for up to eight vehicles and this area has been attractively landscaped. There is also an enclosed garden at the rear. The home is located in Redhill within easy reach of the town facilities and public transport links. The current range of fees for the home is £1,250 to £2,500 per week. Additional charges are payable for: clothing, spectacles, items of personal nature / toiletries, personalised linen; personalised furniture, furnishings / electrical equipment; holidays and outings accommodation and travel costs; aromatherapy and other non-health therapies. There is an e-mail address for this service: ashleighhouse1@aol.com Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is a two star rating. This means that people living in this service experience good quality outcomes. This was the first site visit of a key inspection and was unannounced. Mary Williamson Regulation Inspector carried out the inspection over a period of five hours. The Registered Manager Mahmad Basseer Hulkhory who is also the provider was present for the duration of the inspection. People who use the service are referred to as service users throughout the report at their request. Care Homes for Adults (18-65 years) Page 6 of 27 A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. It was possible to meet one of the two service users living at the home and gain some feedback on what it is like to live in Ashleigh House. It was also possible to talk with some of the staff on duty and to discuss some of the training they had undertaken. The manager completed an Annual Quality Assurance Assessment (AQAA) which provided us with detailed information about the home. The CSCI would like to thank the service user, management and staff for their cooperation and hospitality during this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information available to prospective service users is sufficient to enable them to make a choice about living in the home. No service user is admitted to the home without a full needs assessment in place, to establish if specific needs can be met. Contracts of occupancy outline in detail the accommodation offered, the care provided, and the fees paid. Evidence: The home has a statement of purpose and service user guide in place. This is available to all prospective service users and their relatives, providing them with information to help them make an informed choice about living in the home. This is also available in symbol format. All prospective service users have a needs assessment in place prior to being admitted to the home. This is undertaken by the manager to establish if the specific and individual needs of prospective service users can bet met by the home. There is a detailed assessment format in place, and the needs assessments sampled were Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: comprehensive and informative. Contracts of occupancy are in place. These outline the accommodation offered, the care provided, and the method and frequency of fees payable. All contracts are signed and dated. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual needs and goals are outlined in well maintained care plans, which have been agreed by service users. Systems are in place to support service users to make decisions regarding all aspects of their daily lives. All identified risks have been assessed and recorded, which do not restrict independence either within or outside the home. Evidence: Individual care plans are in place outlining needs and goals and how these are to be achieved. The care plans sampled are well written based on needs assessments. These have been discussed with the service user, agreed and signed. Service users are supported to make choice in all aspects of their daily lives. One service user explained that he likes to go to bed about ten o clock during the week as he attends college, but that he likes to stay up longer at the weekends. He can wear what he likes, and spend leisure time either watching his favourite television programmes or playing with computer games, and colouring. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Assessmnets are in place for all identified risks within the home and community. These are not restrictive and promote independence. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users leisure, recreational and education needs are being met as outlined in individual care plans. Community facilities are accessed, and friends and family links are maintained. Service users are supported to follow a healthy eating plan apprpriate to lifestyle, age and cultural needs. Evidence: Individual leisure and activity programmes form part of the care plan. Service users are supported to lead an active and stimulating lifestyle. An education programme is in place with service users either attending college or school. In addition to this service users participate in swimming in the local leisure centre, attend dance classes one evening a week, visit various towns for personal shopping, attend local cinemas, visit the park, restaurants, and pubs, have trips to the coast , places of interest, and theme Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: parks. Service users were very excited about their first holiday from Ashleigh House to Blackpool the following week. Contact with family and friends is maintained. Relatives are encouraged to visit the home at any reasonable time, unless otherwise stated and documented in care plans. Community facilities are accessed and some service users attend church locally. Catering arrangements in the home are appropriate to service users needs and lifestyle. Menus are displayed in the kitchen and reflect individual need and choice. The main meal is served in the evening and service users take a packed lunch with them on the days they attend college. A service user was being supported to prepare his own lunch and to tidy the kitchen afterwards. One service user explained how he follows a healthy eating plan in order to help him lose weight. For religious reasons a service user does not eat beef. The kitchen is clean, and well equipped and domestic in nature. Staff have a current food hygiene certificate. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care is provided according to preference. Appropriate arrangements are in place to meet the health care needs of the service users, and they are also protected by the medication policy in place. Evidence: Individual care plans outline the personal care provided in the way service users prefer. This is flexible and takes into account education programmes, leisure activities at the weekends, privacy, dignity, and independence. Arrangements are in place to meet the health care needs of the service users. Currently the two service users living in the home have retained their own family GP. Following individual discussion, plans are in place to register with a local surgery. The home has access to a resource centre where service users may access chiropody, and psychology input. Dental care is arranged according to need and choice. The home has a medication administration policy in place. The manager stated that all staff receive training in this policy during induction training. Currently there is one service user taking medication and the monitoring, recording Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: and storage of this is satisfactory. The home has engaged the services of Boots the Chemist to supply the medication for the home and to undertake audits and training when the number of service users living in the home has increased. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and the safeguarding procedures in place protect the service users living in Ashleigh House. Evidence: The home has a complaints procedure in place and all service users and their relatives have access to a copy of this procedure, which is also displayed on the notice board in the main hallway. The complaints procedure is also available in picture format. There have been no complaints made since the last inspection. The home has a safeguarding procedure in place and the manager stated that all staff undertake training in safeguarding vulnerable adults during induction training. There is also a copy of Surreys Multi Agencies Policies and Procedures on Safeguarding Vulnerable Adults in place. The home has used these procedures to investigate a POVA issue. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well mainiained and comfortable and suitable for its stated purpose. The standard of cleanliness is excellent and provides service users with a safe and homely environment in which to live. Evidence: The home is well maintained, comfortable, and furnished to a high standard. Communal areas are spacious providing service users with ample space, which is furnished and equipped according to needs, lifestyle and age. Individual bedrooms are en-suite and decorated to a high standard. Bedrooms occupied have been personalised to reflect individual interests and personalities. The home is clean and hygenic and the standard of cleanliness is excellent. There is an infection control policy in place and arrangements are in place for the collection of clinical waste. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are being cared for by a competent and experienced staff team in sufficient numbers to meet their assessed needs. The staff recruitment procedures protect the service users living in the home. Evidence: The staff duty rota was seen and indicates that the home is providing staff in sufficient numbers with the competence and experience to meet the assessed needs of the service users. Additional staff are provided to support individual requirements and enable them to lead fulfilling lifestyles. Staff development and training is ongoing and this is evident in staff training files. All staff undertake induction training and a record of mandatory training is also in place. Currently 90 of the staff in the home have an NVQ qualification. The home operates a robust staff recruitment procedure. All staff complete an application form, and undertake a written English and arithmetic test prior to employment. A selection of staff employment files were sampled and these are well maintained. They include all the required employment documentation and a CRB (Criminal Records Bureau) Disclosure. Care Homes for Adults (18-65 years) Page 21 of 27 Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the best interests of the service users. The health, safety and welfare of service users and staff are observed and promoted. Evidence: The home is well managed by the registered manager who is also the provider. He has an RMA (Registered Managers Award) and an NVQ level 4. He operates an open and inclusive style of management, and service users are satisfied with this approach. He has the support of the deputy manager who is also his wife. She also has an NVQ level 4. There is senior management support provided over twenty four hours. Qualiy assurance is monitored and the manager stated that the home will achieve Investors in People Award by December 2008. Daily reviews of care take place, monthly health and safety audits, staff meetings, service user meetings, and record monitoring all contribute to quality assessment. Questionnaires are distributed to service users, relatives and other stakeholders for feedback. These are retained in the home and acted upon. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Health, safety, and welfare of the service users and the staff are observed and promoted. All identified risks are assessed to promote safety and good working practice. The home has a wide range of health and safety policies and procedures in place some of which were sighted during the inspection. Fire safety is observed and all staff undertake fire safety training yearly. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. Accidents and incidents are recorded and reported appropriately. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!