Inspection on 24/10/05 for Ashridge

This inspection was carried out on 24th October 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashridge 04/09/07

Ashridge 09/05/06

Ashridge 10/06/05

Ashridge 11/11/04

Ashridge 06/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Ashridge 14 Tower Road Boston Lincs PE21 9AD Lead Inspector Mick Walklin Unannounced Inspection 24th October 2005 10:30 Ashridge DS0000034818.V262943.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 Ashridge DS0000034818.V262943.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. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashridge Address 14 Tower Road Boston Lincs PE21 9AD 01205 366922 01205 354957 ashridge@craegmoor.co.uk 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) Park Care Homes (No 2) Ltd Geraldine Leslie Andrews Care Home 20 Category(ies) of Learning disability (19), Learning disability over registration, with number 65 years of age (1) of places Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th June 2005 Brief Description of the Service: Ashridge is a detached town house situated approximately half a mile from the centre of the market town of Boston. The town has a wide range of amenities including shops, pubs, restaurants and a swimming pool. Accommodation is situated on two floors in the main building, and there is a single storey annex to the rear of the property known as The Beeches. The home is registered for up to 20 service users; 14 in the main building, and 6 in The Beeches. The Beeches provides the opportunity for service users to develop skills in a semiindependent living environment. The home has extensive and well-maintained gardens. They contain lawned areas, patios, vegetable plot and poly tunnel, a summerhouse and a barbecue area. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over seven hours. A tour of the premises was conducted with the manager. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. Other documents connected with the running of the care home were inspected. 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. Ashridge DS0000034818.V262943.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 Ashridge DS0000034818.V262943.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 The Statement of Purpose provides sufficient information for residents, carers and social workers to help them decide if the home can meet the needs of the prospective resident. EVIDENCE: The Statement of Purpose has been amended to reflect the fact that a new deputy manager has been employed. There have been no new admissions since the last inspection, so standards relating to assessment of prospective residents, or trial visits were not inspected. Ashridge DS0000034818.V262943.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, 8 & 9 Care plans are of a good standard, and provide staff with wide ranging information about the support needs of residents, so that their needs can be met. Residents are consulted about the running of the home by means of regular meetings. EVIDENCE: Care plans contain detailed information about the support needs of residents. Care plans are reviewed on a monthly basis, and the home uses an ‘Outcome Based Evaluation’ as well as assessments of daily living needs. Care plans are either signed by the resident to confirm that they agree the contents, or parents sign a care plan agreement. However, it is recommended that these be dated. One resident confirmed that his care plan had been explained to him by staff. Following a recent incident between two residents, there are clear guidelines for staff to prevent further incidents, and the situation has been risk assessed. There are also clear risk assessments covering may activities, which are regularly reviewed. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 9 Residents meetings are held on a regular basis, usually every 3 months, where residents are consulted about the running of the home. At a recent staff meeting, changes to the key worker system were discussed, and staff were asked to discuss the new arrangements with residents. Ashridge DS0000034818.V262943.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): 13, 14 & 17 The home provides a good range of activities, so that residents have an enjoyable and stimulating timetable, by some 1-1 hours have been cut by Social Services, which has affected social opportunities. EVIDENCE: The home offers an in-house day provision for 3 residents, situated in a building in the grounds. Five other residents attend social services day services. There are currently issues relating to funding for some residents, with one having had their 1-1 funding halved, and another having lost all 23 hours funding. The manager explained that this was having a negative impact on social opportunities for these two residents. Residents have had holidays in Norfolk and Skegness this summer. Most residents said that they thought that there are sufficient activities, but one commented that he was bored, with “nothing going on”. However, he then went on to outline what activities he had done over the past week. Some residents have work placements, and one outlined his voluntary work at Pilgrim Hospital. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 11 The home employs a cook, but residents in the Beeches are self-catering. A person living in the semi-independent bungalow stated that they are responsible for their own individual shopping, menu planning and cooking, with assistance from staff. Catering was discussed at the last residents meeting, and they agreed that the menus are nice and varied. Ashridge DS0000034818.V262943.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): 19 & 20 There are good arrangements with local health care providers to ensure that residents health needs are met. Procedures for the storage, administration and stocktaking of medications are safe. EVIDENCE: Two residents were attending GP appointments at the time of the inspection, and one had an audiology appointment. One resident is currently in hospital, and the manager was making enquiries to bring him home. All heath visits and interventions are recorded in the care plan, and all residents have a health action plan, which clearly identifies health needs. Two residents, who currently are receiving treatment, confirmed that staff `had been prompt in requesting GP visits. The home is able to refer directly to Occupational Therapists, Physiotherapists, Speech and Language Therapists and Psychologists if required. Referrals to the Consultant Psychiatrist are via the GP. A Chiropodist visits the home every 6 weeks and local dentists and opticians are accessed as required. Medication storage facilities and administration records are satisfactory. Medication stocktaking checks are completed at each handover. All homely remedies have been agreed with the GP. Ashridge DS0000034818.V262943.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 & 23 Arrangements for dealing with complaints and adult protection ensure that residents are safe. EVIDENCE: There have been no complaints since the last inspection. All residents have a copy of the complaints procedure in their care plans, in written and symbols format. Residents said that they felt confident that staff would take their concerns seriously, but one resident said that he would rather complain to his mum, and let her deal with it. Staff have received recent update training relating to adult protection. A whistle blowing statement was seen to be displayed on the notice board in the office, and staff confirmed that this had been covered in training. Staff demonstrated a sound knowledge of the procedures to follow if abuse was reported to them. Ashridge DS0000034818.V262943.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 provides a comfortable environment for residents, but there is still insufficient communal space in the main building, and some minor maintenance issues were identified. EVIDENCE: The home is generally well maintained and comfortable, with the Beeches providing a high standard of accommodation. Previous inspections have highlighted insufficient communal space in the main building, following the conversion of the office. The manager confirmed that the company has agreed funding to extend the living room with the construction of a conservatory, but no timescales have been given. Therefore the timescale for this requirement has been extended. There was also a requirement relating to damp patches on the ceilings of one of the bedrooms. Investigations into this have been inconclusive, and although the damp originally identified has been redecorated, it has appeared in another bedroom. The carpet in the living room of the main building is beginning to look grubby, and is in need of shampooing. All residents interviewed said that they were happy with their bedrooms. The home was clean and pleasant smelling at the time of the inspection. An additional 12 hours of cleaning cover has been arranged to further improve Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 15 cleanliness. Previous inspections have highlighted that the laundry is of insufficient size. The manager has risk assessed the situation, and the company is looking at the feasibility of enlarging it, although original plans had to be shelved because of a fire exit. As an interim measure, each resident has two days per week allocated for laundry, so that the area does not become too crowded. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 16 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): 33, 34, 35 & 36 Staff are well trained and supported, with sufficient staff to meet the needs of residents. There are excellent arrangements for the induction of new staff. EVIDENCE: The home is fully staffed, with the manager working as supernumerary. Staff commented that staffing levels are better. One said “Staffing is comfortable now, but we were struggling before new staff were taken on”. The home no longer has an administrative assistant, and the deputy manager has had to take on a majority of these duties, which has a negative impact on her contact time with residents. It is recommended that an administrative assistant take on these duties. The files of five newly recruited members of staff were inspected, and all were extremely well organised, with copies of all the documentation necessary for the protection of residents. Staff confirmed that the recruitment and selection process had been formal and thorough. The company produce an excellent induction and foundation workbook, which a member of staff confirmed had been extremely useful during his first few weeks. Progress is reviewed regularly by the manager. Two new staff said that they had been well supported during their first few weeks, and had been allowed to settle in without undue pressure. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 17 Training opportunities were described as “very good” by staff. A training programme is publicised, to enable staff to express interest in courses. The home has an excellent spreadsheet to identify mandatory training updates. All staff have either completed or are studying towards NVQ qualifications, or on the foundation programme. At the time of the last inspection, staff were receiving supervision, but not at the intervals recommended. The company has introduced an Individual Personal Performance Agreement, which firms up the frequency of staff supervision, and monitors staff performance. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 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 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): 38 & 42 The home is well managed and organised, with good staff teamwork and communication. EVIDENCE: Staff said that there is good communication within the home. Regular staff meetings are held, and these are conducted in a way that encourages staff to contribute ideas. One commented, “teamwork is really good – friendly atmosphere and we get on well”. Another said that the senior staff are very helpful and supportive. Health and safety documentation was inspected during the previous inspection. During a tour of the building, it was noted that one of the freezers was running at too high a temperature, and a fridge was running at too cold a temperature. An engineer was called to attend the freezer, and the fridge thermometer was found to be faulty. The home has a Health and Safety Committee, who conduct a quarterly audit. The maintenance person also conducts weekly audits. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 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 3 x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 3 14 3 15 x 16 x 17 Standard No 31 Score 32 33 34 35 36 x x 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashridge Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x DS0000034818.V262943.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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)(a) Requirement The registered person must ensure that adequate communal space is provided. (This requirement is outstanding from 6th April 2004. Some progress has been made, and the timescale has been extended). The registered person must ensure that a solution is found to the damp patches in the upstairs bedrooms. Timescale for action 31/03/06 2. YA24 23(2)(b) 31/12/05 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. 2. Refer to Standard YA6 YA33 Good Practice Recommendations It is recommended that care plan agreements are dated when they are signed. It is recommended that an administrative assistant be employed to take on administrative duties. Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Ashridge DS0000034818.V262943.R01.S.doc Version 5.0 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. 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