Inspection on 14/06/05 for Ashpark House

This inspection was carried out on 14th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashpark House 27/07/07

Ashpark House 06/07/06

Ashpark House 02/02/06

Ashpark House 23/11/04

Ashpark House 02/06/04

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Coopers Mill Ltd

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Paradise Lodge

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Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Ashpark House Peldon Road Abberton Colchester CO5 7PB Lead Inspector Lysette Butler Unannounced Tuesday 14th June 2005 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 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 Stationary 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. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashpark House Address Peldon Road Abberton Colchester Essex CO5 7PB 01206 735567 01206 735567 ashparkhouse@btconnect.com Ashpark House Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home 11 Category(ies) of Learning disability (11) Learning disability over registration, with number 65 years of age (1) of places Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 11 persons) 2 One named person, over the age of 65 years, who requires care by reason of a learning disability, whose name was provided to the National Care Standards Commission in October 2003 3 The total number of service users accommodated in the home must not exceed 11 persons Date of last inspection 23 November 2004 Brief Description of the Service: Ashpark House is a detached house with large, enclosed grounds, in the north Essex village of Abberton, south of Colchester. It’s a rural, village location and was originally bought as a vacant property. It has been tastefully decorated throughout in a style appropriate for the type of residents it is intended for. Ashpark House is registered for 11 residents with learning disabilities, one of whom is over 65 years old. It is divided into two distinct units, one upstairs and one downstairs. All rooms are single occupancy, seven are ensuite and all have good views over the grounds of the home. The proprietors of Ashpark House are Allied Care Ltd. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took seven hours on 14th June 2005. Twenty-four of the forty-three National Minimum Standards were inspected during this visit. It was found that many of the standards had been met or partially met. The overall care and well being of the service users was good; staff and residents were welcoming and happy to speak to the inspector. During this visit the inspector spoke to three residents; five support workers; the area manager and the manager of one of the other local homes in the Allied Care group. The inspector also spent time with the acting manager and her deputy. 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. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 standard(s) Not applicable EVIDENCE: None of these standards were assessed at this inspection. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 & 10 Residents’ individual needs and choices are respected and acted upon appropriately. EVIDENCE: Two care plans were reviewed during this inspection. Both were complete and easy to follow. The new manager was in the process of auditing all care plans using an auditing tool she had devised. Part of the audit being undertaken by the manager is to encourage residents to sign their own care plans with help from their keyworker. Plans were being regularly reviewed and the keyworkers were encouraged to involve the residents in the reviews. Residents were encouraged to make decisions regarding their day-to-day care and what they wanted to do. Some had regular visits to local activities/education centres. Two of the residents were able to look after their own finances with help. There had been a significant improvement in the way residents’ money was handled by head office and the previous problems with opening bank accounts on behalf of the residents was in the process of being sorted out. The care plans reviewed included a chart of the individual resident’s participation in the home and in the local community. Daily progress notes demonstrated that the information on the charts was regularly updated and consulted. Some of the residents have holidays planned for this year. One of the residents did not want to go away from the home for a week so the staff have arranged for them to go on individual days out with two staff members to places of their choice. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 9 Everyday risk assessments were contained in the resident’s individual care plans. The residents’ activities were mainly linked to their own lifestyle choices. Group trips were arranged dependant on the time of year and what the residents requested. The staff were seen to treat the residents with respect during this inspection and there had been no further breaches of confidentially reported to the commission since the last inspection. Staff had all received further training on the issue of confidentiality of information since the last inspection. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15 & 17. The lifestyle of the residents in this home is good and suits their needs. EVIDENCE: Daily routines in this home were flexible and geared to the individual needs of the residents. Some of the residents go out to day centres, or do individual, as well as, group activities within the home. A resident regularly attends educational sessions selected by the residents’ themselves. The newest resident to the home was in the process of arranging regular sessions with the help of their keyworker. One resident told the inspector that they were enabled to go to church every week if they chose to. One other resident occasionally attended church when they wanted to. None of the residents in this home have sufficient capacity to hold down a job. Three of the residents were undertaking educational programmes at the time of this inspection. One of the support workers was undertaking a one to one life skills programme with one of the residents. Group trips were organised for 3-4 residents if they all showed an interest in the same visit. However visits were offered to them regularly for them to choose. Two of the residents regularly go into the village with a member of staff and they are well known by the local community. The home owns its own vehicle to enable them to take residents out and to appointments as necessary. A number of the staff were registered to drive the vehicle when required. All the residents are on the electoral Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 11 register; only one resident showed any interest in voting at the most recent general election. The home still retains a day care coordinator to ensure that the residents were attending activities that encouraged them to achieve their potential. The key worker scheme works well within this home. The staff endeavour to maintain family links, but there are very few relatives that visit the home on a regular basis, especially as the residents themselves are ageing. The new manager is intending to send all relatives a quality assurance questionnaire in the near future. The questionnaire is intended to see if there is anything the home can do to enable them to see the residents more often if they wish to. Meal times are flexible with the main meal of the day being in the evening. Nutritional assessments are regularly undertaken and records of daily intake are recorded in individual care plans. All residents are weighed on a monthly basis. Menus are decided on a weekly basis and the support workers carry out the shopping with any of the residents who wanted to go with them. The support workers were working with one of the residents to enable them to be able to prepare a basic meal for themselves. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 standard(s) 19 & 20. Healthcare and medication procedures are good in this home and protect the safety of the residents EVIDENCE: Residents were dressed in age appropriate, clean and tidy clothing. This home has female residents on the first floor and male residents on the ground floor. The home tries to allocate staff of both sexes on each shift during the day, to ensure resident privacy/ wishes are respected. If the residents were able, they were encouraged to arrange and attend their own GP and hospital appointments with the help of their keyworkers. Some professionals came to the home on a regular basis; for example, the optician and dentist. However the majority of the appointments were arranged outside the home to support independence. GP and medical appointments were documented on a separate sheet in the residents’ care file. During this inspection one resident attended the local hospital for dental treatment. Outreach staff attended the home as necessary/requested. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 13 The acting manager was in the process of reviewing medications polices. The manager was unhappy with the present arrangement through the local GP, as this service relied too heavily on support worker input into the medication administration records and did not make the contents of the ‘Dossett’ boxes clear. The present pharmacist was not supplying the home with printed medication administration records so the senior support staff had to fill them in by hand when they received the medications. A change of medication supplier may also mean that the home will need to consider changing the GP used by the residents. The manager was exploring other suppliers, but had raised her concerns with the present supplier, giving them one month to improve before the home changed. The manager was carrying out a continuous audit of all medications. She also had concerns about a lack of regular review of medications by the local GP. The manager has also instigated a returns system for unused medications, which enabled an audit trail to be followed if needed. There continued to be some concerns regarding training of staff, which is also being addressed. There were no controlled drugs in the home at the time of this inspection, but there was provision to store them correctly if needed. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The policies & procedures in this home protect the residents from abuse and neglect. EVIDENCE: There had been no Protection of Vulnerable Adults (PoVA) issues since the last inspection. The new acting manager has a good working understanding of her responsibilities regarding (PoVA) issues. The staff spoken to demonstrated an understanding of PoVA procedures; the staff are all issued with the Essex PoVA booklet and General Social Care Council code of conduct booklet during their induction. The problems regarding residents’ monies between the home and head office had improved since the last inspection, although there is still no clear audit trail; the acting manager was reviewing procedures at the time of this inspection. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30 The environment in this home is appropriate for the residents it caters for. It is decorated in a domestic style, is clean and tidy. EVIDENCE: There had been no change to the fabric of the building since the last inspection. No residents were using a wheelchair in the home at the time of this inspection however one resident utilised a wheelchair when out of the home. It was clean and tidy throughout the home on the day of inspection. The grounds are extensive and well maintained. Residents help to choose the decoration of their rooms when they are redecorated. The furniture throughout the home was being replaced in rotation. Some of the carpets had been replaced and others were due for renewal in the near future. Fire and Environmental Health Officer visits were up-to-date and there were no outstanding issues. Risk assessments had been carried out on all residents to determine if it would be appropriate for them to have a lock on their door and/or if they can/should hold their own key. The assessments were kept in the residents care files. Two residents held keys to their room at the time of this inspection. Seven rooms in this home have ensuite facilities. The details of rooms are contained in the Statement of Purpose and it is made clear before admission whether the room being offered is ensuite. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 16 Each floor has shared areas, including a kitchen, lounge and dining area. All residents have access to the extensive grounds. All residents in this home are mobile and there is very little adaptation to the home as a consequence. At the time of this inspection one resident was using a walking frame whilst recovering from a fractured ankle. The home was clean and tidy. There were no malodours anywhere in the home. The laundry area is small but clean and tidy, since the last inspection a new industrial style washing machine and dryer had been purchased, which is more appropriate for the amount of laundry generated in this home. The washing machine has a sluicing cycle. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 36. Recruitment and supervision procedures in this home were generally good, ensuring the safety of the residents. EVIDENCE: Two recruitment files were reviewed during this visit. Recruitment files were generally good, containing the appropriate documentation. One did not contain a photograph of the staff member. However a photograph had been seen to enable the staff member to apply for their Criminal Records Bureau declaration, which was clear. The files had been rearranged making them easier to follow. The manager had also made a list for each file noting the areas of the file she wants to further improve. All senior support workers had attended supervision training but the new manager was undertaking all supervision sessions to ensure that she gets to know all the staff. As part of the supervision process the acting manager is putting a policy up every month that the staff have to sign when they had read it. The manager is then asking questions relating to that month’s policy during the supervision sessions. The documentation she is using is clearer and more user friendly. Yearly staff appraisals had been completed for most staff. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38. The new manager of the home has already shown good leadership and her management approach has improved the working relationships within the home. Residents seemed more settled and relaxed. EVIDENCE: As highlighted earlier in the report there had been a change of manager since the last inspection and the staffing situation had improved overall. Consequently the atmosphere in the home was far more settled than at the last visit. The manager was showing good leadership skills and working well with the deputy manger to improve the day-to-day life of the residents. The staff spoken to found the new manager approachable, inclusive and “a good listener”. Staff said they were “…respected for our opinions and we feel listened to”. The staff are clear where the service is going. There were good examples of team working demonstrated during this visit. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 19 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 x x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashpark House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x x x I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 20 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. 2. Standard 20 20 Regulation 12(2) 18(1a & 1c) Requirement The manager must ensure that regular individual medication reviews are carried out. The manager must ensure that all staff who administer medication are adequately trained. Timescale for action 31st July 2005 31st August 2005 3. 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 20 Good Practice Recommendations The manager should arrange for medication administration records to be supplied by the dispensing pharmacist. Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Ashpark House I56-I05 S17754 Ashpark House V228803 140605 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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