Inspection on 23/04/09 for Ashmill

This inspection was carried out on 23rd April 2009.

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

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 06/02/08

Ashmill 25/08/06

Ashmill 22/11/05

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 06/08/2009.

Random inspection report Care homes for adults (18-65 years) Name: Address: Ashmill 141 Millfield Road Handsworth Wood Birmingham West Midlands B20 1EA two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Loraine Dunkley Date: 2 3 0 4 2 0 0 9 Information about the care home Name of care home: Address: Ashmill 141 Millfield Road Handsworth Wood Birmingham West Midlands B20 1EA 01213586280 01213586280 ashmill141@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashmill Residential Care Home Ltd care home 18 Number of places (if applicable): Under 65 Over 65 0 physical disability Conditions of registration: 18 The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Physical Disability (PD) 18 Date of last inspection Brief description of the care home 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 people living at the home. A number of adaptations are in place in order to meet peoples assessed Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home needs. People who live at Ashmill 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. The fee for this home is 650.00- 850.00 pounds per week. Additional charges include those for aromatherapy, hairdressing and chiropody. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: The focus of inspections undertaken by the Care Quality Commission (CQC) is based upon outcomes for people who use the service. The inspection process considers the homes capacity to meet regulatory requirements, national minimum standards and aspects where the service requires further development. This was an unannounced random inspection that took place over one day. We undertook this inspection due to concerns that are currently being investigated under local safeguarding procedures, which indicated that we needed to look at some of the processes within the home. We also did an annual service review 18th February 2009 which identified that there had been a change of management. The home was making efficiency savings which were causing concerns for people living at the home. We concluded that we needed to change our inspection plans due to these concerns. During the visit we looked at the standards relating to meals and meal times, concerns & complaints, protection, staffing and hygiene of the home. We found no evidence to indicate that people were not getting enough food to eat. The home employs two cooks. There is a three weekly menu plan which includes a menu for soft diet. We spoke to six people who live at the home all said they had enough food to eat. Although one person said: We get three meals a day, but they are not following the guidelines on my food. I am supposed to have a soft diet. I choked on baked potatoes. Other comments included: The food is lovely. I can sometimes choose something that is not on the menu. I have no problems with the food and I get enough to eat. I have plenty to eat and have choice of food. We also looked at the kitchen and food storage areas. The dry good cupboard had a fair stock of food and food was being delivered on the day of our visit. There were several fridges and freezers which were well stocked, we only saw a small amount of fresh fruit and vegetables the cook told us they were waiting for these to be delivered. We spoke to both the cook and the responsible person about the amount of money spent on food each week, this was between 500 and 600 hundred pounds per week. We noticed that the food storage areas needed to be cleaned and jars and bottles containing sauces etc. that were opened had not been labeled with the dates. We advised the cook that this needed to be done. The home need to ensure that where people have an identified need for soft diet this is provided, so that people are not put at risk of choking. We found that the current system used by the home for safe keeping of monies for people living in the home was adequate. Money is recorded and checked by two staff. Peoples money is kept in the safe and kept separately. Receipts are kept for each expenditure and are all numbered. Monies are checked once a week and receipts are checked monthly to ensure they correspond. Some people at the home manage their own money, they have lockable tins in their rooms for keeping their money. This should be risk assessed by the home. The previous manager acted as appointee/agent for some people living at the home. We have advised the home that in the future no one at the home should act as agent or appointee for people living at the home and that all financial procedures need to be audited and closely monitored by the responsible person. The home has a complaints procedure and there are systems in place for recording of complaints. We spoke to one persons relative who said they had raised a number of Care Homes for Adults (18-65 years) Page 4 of 11 complaints since November 2008 and had received no response. We found one complaint on record from this person, we could not determine if the person had received a response. There was a written response on record but it was undated and not addressed to anyone. This person said they made a complaint in January 2009 about things going missing we found no record of this complaint. The way complaints are being handled needs to be improved so that people living at the home and their relatives can be confident that their concerns will be listened to and acted upon. We spoke to the manager about safeguarding procedures within the home. The manager seemed unclear as to where the policies were located, and what process would be used to refer under the local safeguarding procedures. On the day of our visit the home looked as if it had not been cleaned for several days. We commented on this to the staff at the start of the inspection. We were reassured that this was due to the time of the day and that the staff on duty would do the cleaning before end of shift at 2.30 pm. At the end of our visit the home had still not been cleaned. A tour of the home showed dirty mops and buckets, residents rooms that had not been cleaned, food storage areas that needed cleaning. The laundry room was untidy and one of the bathroom was stocked with hoist and slings in the bath. The relative of someone living at the home told us that the carpet in the persons room was often soiled with excrement. We noticed that the carpet in this persons room was soiled and used latex gloves had been left on the sink. The persons relative said they had made several complaints about cleaning and laundry but had received no response. One person living at the home said: I suffer from asthma and the dust affects me. Staff we spoke with confirmed that the care workers are now also expected to do the cleaning and laundry as well as caring for people who require a lot of support. The home also needed to be redecorated. We spoke to the responsible person about the deterioration in the hygiene and cleanliness of the home. She confirms that there are plans to redecorate the premises and that this will start shortly. The filing cabinets where care plans and records belonging to people living at the home are kept is broken. This means that confidential information is not kept securely. We spoke to two senior care workers, the manager and responsible person about the staffing levels and rotas. The home has 18 people living there, 16 of whom are wheelchair users and 6 people requires significant support with eating and drinking. Most of the people would require two care workers to support them with their personal care. Usually there are 6 care workers plus 1 senior on the morning shifts, 2 care workers during the night. The morning staff are now having to provide the personal care as well as breakfast cleaning and laundry. In addition a number of staff had left and the home had become reliant on agency workers. We checked the accident book there were two recorded accidents, one of which we were notified about. Both accidents occurred whilst people living at the home were being supported by one care worker. We spoke to people living at the home who were concerned that they no longer spending time with their key worker, and were not pursuing the activities that they were used to. We spoke to the responsible person about the staffing levels at the home. She confirms that the home is having to cut costs due to financial pressures. We have told the home that they must review the staffing levels to ensure that people receive support in a safer way and that there are dedicated staff to ensure the home is kept clean and hygienic. This to include the numbers of staff on night duty. Given the needs of the people living at the home it may be more appropriate that a member of the night staff is a senior care worker. Care Homes for Adults (18-65 years) Page 5 of 11 One person we spoke to said they no longer wished to live at the home. Another person was concerned that staff were continually moaning about the changes and this was causing distress. What the care home does well: 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 2. Care Homes for Adults (18-65 years) Page 6 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 11 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, 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 10 17 The registered provider must 25/05/2010 repair or replace the filing cabinet where confidential records for people lining in the home are kept. This is to ensure that people are confident that information about them is handled properly and in confidence. 2 17 12 The registered provider must 24/04/2009 ensure that where people living at the home have an assessed needs for specific dietary requirements these are provided in a consistent way. This will ensure that people enjoy their meals and do not feel they are at risk of choking etc. 3 22 22 The registered provider must 23/07/2010 ensure that where people who use the service and their representative make complaints, these are fully investigated and responded Page 8 of 11 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 to. This is to ensure that people who live at the home and their relatives feel that their views are listened to. 4 30 16 The registered provider must 25/05/2009 ensure that all parts of the home is kept clean and hygiene at all times. This is to ensure that people live in a clean and hygienic environment. 5 33 18 The registered provider must 23/07/2010 review the staffing levels to ensure that this are sufficient staff to meet the needs of the people living in the home. This to include the numbers of staff on night duty and dedicated staff for cleaning and laundry. This will ensure that care is provided in a safe way and people live in a clean and hygienic environment. 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 23 The person managing the home needs to be fully aware of the location of all relevant procedures relating to safeguarding of individuals. The registered provider needs to ensure the programme of redecoration of the home takes place as planned. This will Page 9 of 11 2 24 Care Homes for Adults (18-65 years) 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 ensure that the environment is enhanced for people who live at the home. 3 33 The staffing levels on night duty to be permanently increased to three staff whilst the level of needs of people living in the home remains high. One member of staff on night duty is at least at the level of a senior care worker. The responsible person needs to ensure that all practices and processes within the home are regularly monitored for effectiveness. That the views of people and their relatives are taken into account and acted upon. That staff are monitored so that they do not burden people living at the home with issues that need to be addressed by management. That there are process in place to enable staff to to air their views in a constructive way. 4 43 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. 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