Inspection on 11/12/06 for Ashley House

This inspection was carried out on 11th December 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashley House 05/12/08

Ashley House 21/10/05

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

CARE HOME ADULTS 18-65 Ashley House 9 Cope Road Banbury Oxfordshire OX16 2EJ Lead Inspector Catherine Kane Unannounced Inspection 11th December 2006 16:00 Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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 Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashley House Address 9 Cope Road Banbury Oxfordshire OX16 2EJ 01295 261463 01295 261463 haroon@caretech-uk.com 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) CareTech Community Services (No. 2) Ltd Mrs Deborah Jill Bleach Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (1) of places Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons accommodated at any one time must not exceed 3. 21st October 2005 Date of last inspection Brief Description of the Service: Ashley House is a semi detached family house situated close to local shops and facilities in the centre of Banbury. It is home for up to three people with a learning disability. All enjoy a high level of independence and are supported by staff to be as independent as possible. The home is run and managed by CareTech Community Services (No. 2) Ltd., an organisation with experience in providing care services for people with learning disabilities. The fees for this service range from £405.88 to £515.11 per week. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 4pm on Monday, 11 December 2006. She was in the service for one and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The registered manager was on duty at the time of the inspection. The inspector spoke with the member of staff on duty. The inspector spent some time with all three residents, was present while they were preparing for their evening meal and she saw how staff help residents look after their medicines. She also looked at residents’ care plans and other records kept in the home and made a tour of part of the premises. The inspector would like to thank the manager and her staff team for their assistance with the inspection. She also thanks residents and all others who shared their experience of this home. What the service does well: The home continued to have a friendly, relaxed atmosphere with positive relationships between residents and staff. Staff had a good understanding of residents’ support needs. Meals provided are good. Personal care and healthcare support provided in this home are good. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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 Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure is good although not tested, as there have been no new admissions to the home. EVIDENCE: There have been no new admissions to this home since the last inspection. At the time of this inspection the home had no vacancies. Generally, admissions would not be made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the Statement of Purpose. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system in place to provide staff with the information they need and for assessing risk is adequate. EVIDENCE: The inspector viewed the files for two residents; each had risk assessments completed and were up to date with essential information that staff need to be able to care for each resident. The files were neat and tidy but bulky and were not easy to read. The home uses a care planning system that promotes the use of charts and task checklists for staff. The inspector recommends that the care plan file system should be made easier to handle and read and produced in a format that residents could read. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for people who use this service to take part in a variety of interesting activities are good. EVIDENCE: On the day of the inspection the inspector was in the home during the late afternoon. She spent the time with all three residents, the manager and the staff on duty. All three residents had very good communication skills and were confident to let the inspector know about things that are important for them. One resident told the inspector “I’m happy I haven’t a care in the world” Many activities provided in house were based on what residents prefer to do in their leisure time; these included relaxing in their bedroom, watching TV, listening to music Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 11 and knitting. Each resident has regular activities outside the home that includes attending day services, regular outings and social clubs. All three residents have contact with their families and this is very important to them. The inspector was in the home while residents were preparing for their evening meal. Regular drinks and snacks are available. A varied menu is provided and residents’ special dietary needs are catered for. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of residents are well met. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their medication and see they get to see their local GP and other community healthcare services when needed. Three comment cards were returned to the inspector; from the residents’ GP, a consultant psychiatrist and a care manager. Each indicated that they were generally satisfied with the overall care provided in this home. Residents’ medicines are securely kept in a locked medicines cabinet located in the home’s office or in locked cabinets in residents’ bedrooms. The home uses a pharmacist produced medication administration record (MAR). Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 13 The manager confirmed that records were kept of staff assessed as competent to administer residents’ medicines. During the inspection the inspector looked at how residents’ medicines are looked after and discussed with the manager how residents are helped to take their medicines. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a protection from abuse policy and the complaints procedure is good. EVIDENCE: The manager declared that the home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures in line with the Oxfordshire Multi-agency Codes of Practice. The Commission has received no information relating to adult protection issues in the last year. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was tidy and clean at the time of the inspection but is in need of refurbishment and redecoration. EVIDENCE: During this inspection the inspector had a tour of the shared areas and was invited by a guest to see their bedroom. The lounge, dining room and kitchen were furnished and decorated in a modern style and were clean and tidy at the time of the inspection. The paintwork in most areas of the home, including residents’ bedrooms, was damaged and in need of redecoration. The ground floor WC is cracked and needs to be replaced. The lack of adequate water pressure in the ground floor shower means that the water often runs cold; this is unsatisfactory. The first floor bathroom is functional but is old and in need of modernisation. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 16 The staff team has raised several of these issues over a period of months, these need to be addressed without delay. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. At the time of inspection staffing levels appeared to be appropriate for the needs of the current resident group to be met. EVIDENCE: During the inspection the inspector spoke with one member of staff. They commented that morale is good. Since the last inspection there have been no changes to the staff team providing excellent continuity of care for the three residents. Two residents, helped by staff, returned questionnaires to the inspector where they indicated that they know who to talk to if they are unhappy and that staff always treat them well. The recruitment process is thorough; staff files were seen to be in order by the inspector at the previous inspection. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 18 have undertaken. One staff member is currently undertaking a National Vocational Qualification (NVQ). Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It is expected that the registered manager shall undertake further training qualifications at level 4 NVQ in both management and care. Therefore, this standard is rated as ‘standard almost met’ scored 2. The registered manager is currently undertaking the Registered Managers Award. The registered manager is competent to run the home and meet its stated aims and objectives. The manager has sound knowledge and experience in care of people with a learning disability, quality assurance systems, equal opportunity issues, development and implementation of the service’s policies and procedures, good people skills, strong leadership of staff which leads to Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 20 confident workers, responds to need and provides good role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running of the home and is aware of current developments, both nationally and by CSCI, and plans the service accordingly. The home, generally, has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were generally adequate and are routinely completed. Proprietors’ representative’s monthly visit reports have been regularly received. The Commission no longer requires that a copy of this report be sent to CSCI but a copy must be kept in the home and made available for inspection. CareTech has undertaken an audit of this home. This report was not yet available but the manager stated that she had achieved well with positive outcomes. CareTech, who run this service, has financial and accounting systems subject to internal and external audits. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2) Requirement The registered person must provide details of the renewal, maintenance and repair programme for the home, internally and externally. Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The inspector recommends that the care plan file system should be made easier to handle and read and it should be produced in a format that residents could read. Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 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 © 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 Ashley House DS0000065399.V323500.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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