Inspection on 22/11/05 for Ashmill

This inspection was carried out on 22nd November 2005.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashmill 23/06/09

Ashmill 23/04/09

Ashmill 06/02/08

Ashmill 25/08/06

Ashmill 02/06/05

Ashmill 07/01/05

Ashmill 01/07/04

Ashmill 26/01/04

Ashmill 07/08/03

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

CARE HOME ADULTS 18-65 Ashmill 141 Millfield Road Handsworth Wood Birmingham West Midlands B20 1EA Lead Inspector Sue Houldey Unannounced Inspection 22nd November 2005 09:30 Ashmill DS0000016719.V267588.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 Ashmill DS0000016719.V267588.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. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashmill Address 141 Millfield Road Handsworth Wood Birmingham West Midlands B20 1EA 0121 358 6280 0121 358 6280 ashmill141@hotmail.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) Mrs Tuula Marjukka Khan Alison Shaughnessy Care Home 18 Category(ies) of Physical disability (18) registration, with number of places Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 2nd June 2005 Brief Description of the Service: Ashmill is registered to provide personal care and support to 18 adults with a physical disability, who have been assessed as requiring full assistance with daily living tasks. The service is staffed twenty four hours a day including two waking night staff. The full range of medical services, leisure and social activities are provided for the service users. A number of adaptations are in place in order to meet the assessed needs of the service users. Service users are encouraged and supported to maintain links with their families and the local community. The service is situated in the Handsworth Wood area of Birmingham in a quiet residential road. It is close to local amenities and there is parking available at the front of the premises. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 9.30 am and 1.45pm. The inspector met with the manager, deputy, and senior carer. In addition the inspector spoke with five residents and two relatives, briefly toured the building and examined records. The people living at Ashmill prefer the term residents to service users and so this has been adopted throughout this report. What the service does well: 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. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 6 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 Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 7 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, 4 Prospective residents have information provided to them through the service users guide which assists in deciding on the suitability of Ashmill in meeting their needs and aspirations. The home has a comprehensive assessment tool, which assists in determining if the home is able to meet the needs of prospective residents. EVIDENCE: The home has a comprehensive service user guide, which has been updated since the last inspection. This is available to any prospective resident and their family to assist in making a decision about the suitability of the home in meeting their needs. The home has developed a comprehensive assessment tool to be completed prior to any visit to the home by a prospective resident. In addition the home uses this tool to record the outcome of any trial visits, which are arranged. No pre admission assessments have been completed since the last inspection of the home, and no new residents admitted. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 8 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 Daily records lack detail and could lead to changes in needs not being picked up and acted upon by staff. The home does not have sufficiently robust systems to ensure that residents are not placed at risk during the night time period. Residents are encouraged to participate in decision making in the home. EVIDENCE: Care plans were not examined at this inspection. Daily records which are maintained contain insufficient detail to determine whether the needs of residents are being met, and do not document changes in need. None of the records examined reflected for instance, on the range of activities which staff and residents report are available. Residents and their relatives confirmed that they are involved in decision making in the home. This is on an individual basis, and through regular documented residents meetings. Residents and their families were confident in these processes and that their views are known and rights are safeguarded. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 9 Residents participate in the day to day running of the home through individual consultation and the regular residents meetings. Evidence is available that residents received feedback on their participation in these processes and action plans are available to address issues raised through these discussions. This assists residents to feel valued and acknowledges their status in the home. Some of the residents use communication boards or light writers to communicate. Staff were seen to assist those who needed help to communicate. Staff were patient and did not pre-empt what residents wished to say. Where it was not clear for instance, which letter a resident had pointed to this was checked out by the member of staff. These good practices ensure that residents are fully engaged, and their communication listened to and valued by staff. Manual handling and challenging behaviour risk assessments and strategies have been developed and are subject to review. These ensure that residents and staff are not placed at risk of accident or injury through inappropriate manual handling. In addition strategies ensure that residents are supported consistently by the staff team, who acknowledge and understand that some incidents of challenging behaviour may be poorly understood or not remembered by the resident who will need support throughout any incident. Many of the residents have bedsides, which prevent them from rolling or falling out of bed. The manager told the inspector that in some instances the resident had requested these. However, the manager confirmed that risk assessment had not been carried out in all instances, which could lead to residents being placed at risk of injury. Night waking checks are carried out at regular intervals throughout the night. Residents confirmed that staff are prompt in attending to their needs, recognising that they may need to wait a couple of minutes if another resident was being assisted. Residents felt that this was acceptable and that their needs were met promptly enough. The frequency of night time checks has not been determined through risk assessment. This could place residents at risk and does not take account of individual needs, wishes or preferences. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 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 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 have the opportunity to participate in a range of leisure and education activities. Residents are supported to maintain the relationships, which they value. Respondent’s rights are respected and their wishes adhered to by the staff team. Residents receive a nutritious, wholesome and balanced diet, of their choice, which respects cultural and religious needs and wishes. EVIDENCE: The home employs staff who are responsible for co-ordination of education opportunities, and leisure activities. Residents told the inspector about the opportunities which are on offer, which include access to day centres and college courses, as well as a range of leisure activities such as visits to shops and pubs. In addition the home has computers with internet access, games, television and a sensory room. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 11 Some residents are waiting for funding for college and day centre activities, which they find frustrating, but recognise that staff are pursuing this and advocating on their behalf to secure appropriate funding. Residents were happy with the range of activities both within the home and community, they feel valued and enabled to access ‘normal’ activities. On the day of the inspection two relatives visited residents, and spoke to the inspector. Both were happy that the home offered appropriate support to them to maintain their relationships with their relative. Residents told the inspector that maintaining links with families and friends was encouraged, and staff assist in every way possible, and it is recognised how important and valued these links are. Residents told the inspector that daily routines are totally flexible. Their wishes in respect of time of getting up, going to bed and receiving personal care are responded to by the staff team. The cook showed the inspector a menu, which is used as basis for planning meals throughout each day. On a daily basis, resident’s choices are sought; the inspector saw at least five different choices on offer for the evening meal. Food is stored appropriately and temperate checks made of fridges and freezers to ensure the food presented is of good quality. There is a separate fridge for the storage of Halal food, which ensures residents cultural needs and wishes are adhered to. Residents told the inspector that they can always have a choice and that they enjoy the food. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 &20 Residents have aids and adaptations, which maximise their independence. Attention to cleaning of wheelchairs would ensure that the dignity of residents is maintained. The storage and administration of medication ensures that residents are protected and receive the medication they require. EVIDENCE: The home has a mobile medication trolley, which is securely stored. The records for administration and systems for storage were found to be entirely satisfactory. Residents have a range of equipment available to maximise their independence and facilitate communication. One resident told the inspector about the support he had been offered to ensure he got the equipment needed. Three electric wheelchairs were seen to be unclean, this detracts from the dignity of the resident. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 13 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 Residents are supported to voice their views of the home. Concerns or complaints are addressed promptly and to the satisfaction of residents EVIDENCE: The service user guide provides details of the homes complaints procedure. Three residents told the inspector that they had confidence that any concerns or complaints that they raised either with staff, the manager or through the regular residents meetings have been or would be in the future acted upon promptly and to their satisfaction. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 14 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 & 30 The home is maintained to a good standard of hygiene and cleanliness. Bedrooms reflect the individual needs and interests of the residents. Aids and adaptations are available which maximise the independence of residents. EVIDENCE: A brief tour of the home showed that all areas were maintained to a good standard of hygiene and cleanliness. Aids and adaptations were available which maximise the resident’s ability to move around safely and as independently as possible. The home is decorated to a good standard. Each of the bedrooms reflected the taste and interests of the resident. Residents told the inspector that they liked their room and their privacy was respected by staff. This contributes to the homely atmosphere and overall well being of residents. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 15 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): 32, 33,34 & 36 Residents are supported by a staff team who are competent and qualified to meet their needs. Staff are available in sufficient numbers to ensure that needs are addressed promptly. Improvements made to the recruitment systems for staff have provided further safeguards for residents. Staff receive individual supervision on a regular basis, which ensures they offer appropriate levels of support and assistance to the residents. EVIDENCE: There is evidence in staff supervision files that the home is providing opportunities for staff to reflect on their practice to ensure that resident’s needs are met. The home has over 50 of the staff team qualified to NVQII or above, and there is evidence within supervision files that staff who have not already had the opportunity to attend this training wish to do so. The numbers of staff on duty on the day of the inspection appeared adequate to meet resident’s needs. Residents told the inspector that there are always enough staff to ensure they have a choice of who supports them. This includes the choice of male and female staff, which promotes a sense of well being in residents. The home has developed an assessment pro forma to be used during the recruitment stage for staff. This ensures that the home is consistent in its approach, and ensures that decisions can be scrutinised, offering protection to residents. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 16 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 & 42 Residents benefit from a well run home, whose ethos is inclusion and where residents views are valued. Further development of risk assessments will ensure that residents are safeguarded further during the night time period. EVIDENCE: The manager of the home is continuing towards completion of the Registered Manager award. Residents and relatives who spoke to the inspector were unanimous in their praise of the manager and deputy, who they feel run the home well and in a way, which values their input and ideas. The latest quality audit of the home, for July 2005, demonstrates that the views of staff, relatives, visitors and residents are sought in order to ensure that the home is run in a way, which meets and exceeds their requirements. An action plan is attached to the audit, which sets out how the home intends to address any concerns raised. Further attention is needed to the development of risk assessments and risk management strategies to support night time practices. This will ensure that resident’s needs and wishes are adhered to and that residents are not at risk of injury from bedsides. Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 17 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 X X 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashmill Score 2 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 2 X DS0000016719.V267588.R01.S.doc Version 5.0 Page 18 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 YA6 Regulation 15 Requirement The manager must ensure that daily records reflect the full range of opportunities provided. In addition the care offered, care received and response to care must be documented The manager must develop risk assessments in relation to: the use of bed sides and nature and frequency of night time checks All equipment including wheelchairs used by residents must be maintained in a clean condition. Timescale for action 22/12/05 2 YA9YA42 13(4) 22/12/05 3 YA18YA30 23(2) 22/12/05 Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Birmingham Office 1st Floor, Ladywood House 45-46 Syephenson Street Birmingham B2 4UZ 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 Ashmill DS0000016719.V267588.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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