Inspection on 12/01/09 for Ashleigh [Minchinhampton]

This inspection was carried out on 12th January 2009.

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

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.

Other inspections for this house

Ashleigh [Minchinhampton] 13/01/07

Ashleigh [Minchinhampton] 09/02/06

Ashleigh [Minchinhampton] 26/09/05

Ashleigh [Minchinhampton] 12/10/04

Ashleigh [Minchinhampton] 20/07/04

Ashleigh [Minchinhampton] 17/02/04

Ashleigh [Minchinhampton] 03/12/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashleigh [Minchinhampton] 3 Box Crescent Minchinhampton Glos GL6 9DJ     The quality rating for this care home is:   one star adequate 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: Paul Chapman     Date: 1 2 0 1 2 0 0 9 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 29 Information about the care home Name of care home: Address: Ashleigh [Minchinhampton] 3 Box Crescent Minchinhampton Glos GL6 9DJ 01453886636 Telephone number: Fax number: Email address: Provider web address: jo@ggh.org.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Joanne Wheeler Type of registration: Number of places registered: Gloucestershire Group Homes care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accomodated is 3 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Ashleigh is a semi-detached house with accommodation for three adults with Aspergers Syndrome/Autism. This home differs from other homes within the organisation as the service users display more autistic needs. The organisation offers a very specialised, individual service for its service users, and staff receive training to support them appropriately. The home is situated in Minchinhampton, near Nailsworth and enables service users to access local community facilities such as shops, take aways, chemists and a Post Office. Service users also have access to transport that is provided by the home and this enables them to access facilities in several other local towns. Family and friends are welcome to visit the home at any time and service users can meet them in Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home private if they wish to. The service users attend various activities, which include Day services provided by Gloucester Group Homes and college courses. The inspector has visited the day service that is provided by the organisation. It has been developed specifically for people who have Aspergers syndrome/Autism and offers service users very individual programmes to meet their needs. Care Homes for Adults (18-65 years) Page 5 of 29 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: one star adequate 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: We visited the home unannounced on January 12th but were unable to complete our inspection as staff and people living in the home were about to go out. We spoke to the manager after this and arranged to visit the service while they were there on Thursday January 15th. On arriving at the service two of the people were going out to complete activities at a local college whilst another person was staying at home. The manager met us at the service and we completed a tour of the home. After looking around the home we spent time with the manager examing the care of two people in depth. This involved looking at their care files for details of their needs assessments, care plans, risk assessments, health needs, financial management and other records kept by staff from day to day. Whilst completing this site visit we were able to speak with one person living in the home. Observations during our visit showed that staff treated this Care Homes for Adults (18-65 years) Page 6 of 29 person with respect and there appeared to be a good relationship between the person and the staff supporting them. In addition to speaking with the manager we also spoke to one member of staff. As part of the inspection process the manager was asked to complete an AQAA (Annual Quality Assurance Assessment). This document forms part of the inspection process and asks the manager of the service what the service does well, what it could do better, what has improved and what the planned improvements are for the next twelve months for each of the eight outcome areas for the Younger Adults National Minimum Standards. 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 Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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 29 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 organisation has an admissions policy and this should ensure that any future admissions to the services are managed effectively. Evidence: The organisation has an admissions policy. There have been no new admissions to the service since the previous inspection was completed. As there have been no new admissions to the service since the previous inspection we did not assess standard 2 on this occasion. Care Homes for Adults (18-65 years) Page 11 of 29 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. Care plans, risk assessments and goal plans provide staff with good information that enables them to meet peoples needs whilst maintaining their safety. Evidence: We examined the care of 2 people in depth looking at their plans of care and associated documents including risk assessments. The registered manager explained that the organisation will be implementing a new care planning system in the near future. They showed us a copy of the template for the new system. Examining these records showed that staff had completed an annual review of peoples assessed needs. These were based on the records kept by staff over a year and identified whether peoples skills had improved or deteriorated in the areas of personal care and domestic tasks. These reviews then enabled the staff to identify goals, and Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: review plans of care for the future. Both of the files we examined contained identified agreed goals. An example of this was one person preparing dinner, this was broken down into six smaller objectives. Records in the persons file showed good evidence of staff supporting them to achieve this goal weekly (as agreed) and highlighted the persons progress towards the goal. The other file we examined also provided good evidence of the person being supported to achieve their goals. The goal plans we saw were well written and enabled staff to support people consistently. Annual care reviews are completed with each person and notes were available to support this process. In one of the files we examined a person had written their own notes to support their review, this is seen as good practise. We spoke to one member of staff as well as the registered manager. Both were able to give us a number of examples of people being able to make decisions in their day-today lives, these included about the food and meals provided in the home and activities. We spoke to one person who lived in the home who appeared to be happy with the service they were receiving. The two other people were out completing activities at the time of this site visit. Each of the files we examined contained an individual risk assessment policy that summaries potential risks specific to the person. From this document a range of risk assessments were completed to minimise potential risks. All of the risk assessments we examined were reviewed at regular intervals or sooner as required. The AQAA completed for the home states that staff will continue involving people living in the home in any decisions affecting their lives, while being aware of how their autism impacts on their lives. Care Homes for Adults (18-65 years) Page 13 of 29 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. People lead varied and active lifestyles that are led by their interests and needs with the support of the staff team as required. Evidence: At the time of this site only one person was at home as it was their training day. The two other people were out completing activities at a local college. On the wall in the homes kitchen was a copy of timetables for each person. The manager sent us copies of these documents after the inspection. Timetables showed that all three people take part in a range of activities, either together or individually. Examples of activities included: - attending local colleges, swimming, horse riding, the organisations day service and using local community services. Every week each person has a training day where they will be supported by staff to Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: complete tasks such as cleaning around the house, changing bedding, washing clothes and baking cakes. All of the timetables we saw identify people having a lie-in at least once a week. Family and friends are welcome to visit people in the home and there were a number of examples of people meeting with parents/family. Staff support people to do this where it is required. The registered manager explained that holidays were being planned at present and that each person will have 7 days holiday. This can be taken in one go, or in parts (depending on what people want). The menu for the following week is chosen each Sunday. The three people living in the home meet with staff and decide what they would like. Records show that where possible people are supported to prepare their own meals. Timetables and menus showed that each Saturday people have the choice of eating out. Menus also showed that people have a healthy varied diet. The AQAA states that over the next 12 months staff will continue to introduce more healthy options for meals and more opportunities to exercise. Care Homes for Adults (18-65 years) Page 15 of 29 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. The personal care and health needs of people in the home are addressed appropriate and this minimises potential risks to peoples health. Medication administration is managed effectively and this minimises potential risks. Evidence: Peoples personal care needs are met. All of the people in the home are able to complete their own personal care and staff support with prompts. The registered manager stated that they are about to implement health action plans for each person. Current medical records provide the reader with detailed information about medical issues and the input of other professionals to meet those needs. Each month staff complete a health check for each person. If staff notice anything out of the ordinary they then support the person to receive the appropriate treatment. All of the staff have completed accredited medication administration training at a local college since May 2007. When examining medication administration records we found Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: a few gaps where staff should have signed to confirm people received their medication. The manager was aware of these gaps and stated that they had followed these up with staff. Medication reviews are completed regularly with people. No one administers their own medication and the registered manager stated that this may be something to be looked at in the future. Homely remedies are purchased as required and the pharmacist or GP will be asked to approve the medication as safe at that time. Medication is checked when it enters the home and there is a record of any medication that requires disposal. Care Homes for Adults (18-65 years) Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure that enables people to make a complaint if they are unhappy and provides staff with clear procedures about how they should respond. Records of income and expenditure minimises potential risks to peoples finances by providing a detailed audit trail. Evidence: The home has a complaints procedure that is produced in an appropriate format that enables people living in the home to make a complaint if they are unhappy. There have been no complaints made to the manager since the previous inspection was completed. The CSCI have not received any complaints about the service. Training records showed that staff last completed safeguarding vulnerable adults training 3 years ago. Speaking with the manager they agreed that staff should now complete refresher training, this becomes a requirement of this inspection report. The AQAA completed for the service highlights the need for maintaining the ongoing safeguarding adults training. At present none of the people living in the home manage their own finances and staff are responsible for recording income and expenditure. These records provide good evidence and enable audits of peoples income and expenditure. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The AQAA Care Homes for Adults (18-65 years) Page 19 of 29 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 property provides people with a homely, comfortable and pleasant environment that meets their current needs. Evidence: We completed a tour of the home with the manager. The home is a semi-detached property on the edge of the Minchinhampton and provides people with a good-sized lounge, conservatory and kitchen for communal areas. Each of these areas are nicely decorated and personalised with peoples possessions. In the lounge there is a range of comfortable chairs, a TV and a stereo. The bathroom and toilet in the property is situated downstairs. Speaking to the manager they explained that they have asked the landlord to address the flaking paintwork on the ceiling of the bathroom, and this has repaired on a number of occasions. It is recommended that the manager speaks to the landlord about this again. Each person has an individual bedroom. None of the rooms were seen on this occasion. The AQAA stated that one person would like to have satellite TV in their bedroom and that staff are working with them at the moment to achieve this. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: At the time of this site visit the home was clean and tidy. One of the people living in the home was busy cleaning around the home at the time of our visit. A gardner has been employed to maintain the outside of the property. Care Homes for Adults (18-65 years) Page 21 of 29 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. People living in the home are supported by an experienced and committed team and this minimises the risk of their needs not being met. Staff receive regular supervision from the manager. Evidence: The staff team is made up of 3 staff which have all worked at the home for a number years. The experience of the staff team helps to provide people living in the home with a consistent approach to their care based on their knowledge of people in the home. The organisation has a bank of temporary staff that cover shifts at the home as required. This is good practice and helps to ensure that people continue to receive a conisstent service from staff that they know. As part of this site visit we spoke to a member of staff on duty. They stated that it was a good place to work and felt supported by the manager. They stated that the manager worked a number of shifts in the home and had a good knowledge of peoples needs. All 3 staff have the opportunity to receive regular supervision with the manager. One person refuses supervision and records supplied to us showed that the other two staff Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: receive regular supervision. At the time of this site visit two staff had received an appraisal in the previous week and the other member of staff was booked to have their appraosal in the week following this site visit. No new staff have been employed since the previous inspection was completed, therefore we did not assess standard 34. The AQAA states that since the previous inspection application forms have been updated and now require applicants to provide a record of all previous employment. Training records showed that since the last inspection was completed all three staff have completed training in fire safety and medication administration. Planned training for the coming months included staff attending training in the Mental Capacity Act (2005), first aid and one person completing their NVQ (National Vocational Qualification) level 2 in social care. Two staff have already completed their NVQs in social care. Care Homes for Adults (18-65 years) Page 23 of 29 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 and people receive a good quality service from an experienced and committed team. Health and safety risks are taken seriously and regular checks and staff practises minimise potential risks to people. Quality assurance systems do not meet the criteria of these standards. Evidence: The registered manager has an extensive knowledge of this client group after working with them for a number of years. This inspection has shown that this service is well managed with peoples needs being identified and met by a highly knowledgeable and committed staff team. Record keeping in the home is excellent and provides good evidence of the service being led by the needs of the people living in the home. Where a service provider is not in day-to-day charge of the home Regulation 26 of the Care Homes Regulations (2001) states that monthly unannounced visits should be completed by them, or their representative. Records examined by us showed that over the past 12 months these visits have been completed monthly, as required. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: At present the home does not have a quality assurance system in place that meets the criteria of standard 39. The provider is aware of this and is currently developing a procedure to address this. It becomes a requirement of this report that a quality assurance system is developed and implemented. The organisation has a range of policies and procedures that meet the criteria of these standards and all of these documents have been reviewed since the previous inspection was completed. A range of regular checks are completed to to minimise the potential health and safety risk poised to people living in the home. We saw records to confirm that hot water outlet temperatures are monitored weekly, a food is used to test cooked meat, fridge and freezer temperatures are monitored daily, Portable Appliance Testing (PAT) was completed in July 2008, all fire safety checks are completed as required and accidents are recorded thoroughly. In addition to these daily/weekly/monthly checks an annual health and safety audit is completed where each room is individually assessed. This is a good practise. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 1 23 13 (6) All of the staff must complete safeguarding vulnerable adults training. Completion of this training will provide staff with up to date information and practises and therefore minimise the potential risks to people. 01/05/2009 2 39 24 The manager must develop and implement a quality assurance system. An effective quality assurance system will allow the manager to provide evidence of reviewing and improving practises to meet peoples wishes and needs. 06/03/2009 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 1 27 The manager should arrange for the propertys landlord to repair the ceiling in the bathroom. Page 27 of 29 Care Homes for Adults (18-65 years) Care Homes for Adults (18-65 years) Page 28 of 29 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 © (2009) 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. 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