Inspection on 04/09/07 for Ashridge

This inspection was carried out on 4th September 2007.

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

Ashridge 09/05/06

Ashridge 24/10/05

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 David Bacon Key Unannounced Inspection 4th September 2007 08:30 Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashridge Address 14 Tower Road Boston Lincs PE21 9AD 01205 366922 01205 354957 ashridge@craegmoor.co.uk Craegmore.co.uk Park Care Homes (No 2) Ltd 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) 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.V339679.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Learning Disabilities (LD) Learning Disabilities over 65 years of age (LD (E)) The maximum number of service users to be accommodated is 20 One bed in the category LD may be used for a service user under the age of 18 until their 18th birthday is reached. This person is named in the Pre Registration Letter dated 9 December 2005. 9th May 2006 2. Date of last inspection 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. Copies of inspection reports are kept in the office for service users and members of the public. The range of fees is from £407 to £824 per week. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during September 2007 and the visit to the home was undertaken over approximately 5 hours. The care received by three residents was looked at in detail. This process is called “case tracking” and individual residents care records and general home records were looked at as part of this along with discussions with residents and their representatives about their experience of life within the home. The inspector spoke with five residents and three resident’s representatives, two staff members, the registered manager and deputy manager. Prior to the visit, the inspector reviewed the previous inspection report and any information relating to the service since that inspection was assessed as part of the overall review of the service. A partial tour of the premises was conducted including areas relating to the residents who were case tracked. Staff records were also inspected along with policies/procedures and administrative systems. What the service does well: What has improved since the last inspection? What they could do better: There is still not enough communal space for residents in the main building, and some minor repair work remains outstanding from the previous inspection visit. Also, some décor is basic and the programme of decoration would benefit from being increased to create a more pleasant environment for residents. There are insufficient activities, provided by the home for residents, which does not align with the organisations description regarding the activity provision in the homes statement of purpose. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are satisfactory procedures for assessing and introducing new residents to the home. EVIDENCE: A statement of purpose is displayed in the home, which provides prospective residents and their representatives with a brief description of the services provided. However, some of the information contained within this document was incorrect. For example, the statement regarding activities was not consistent with the activities being made available to residents. The assessment of residents needs has been improved since the last inspection, which has involved utilising a new care recording system. The three care plans viewed identified resident’s care needs and included a brief history, likes, dislikes and any day-to-day routines and preferences. Any specialist supporting services input was included and provided guidance for staff. Records demonstrated where residents had been involved in the assessment process. Individual contracts are in place, which set out the terms and conditions for living at the home. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 9 Prospective residents are encouraged to visit and or stay at the home prior to admission and that this timescale is flexible, as per the needs of the individual. Admissions are for an eight-week trial period although this can be extended. The residents and representatives spoken with were satisfied with admission procedures and said: “We were all made welcome, they visited twice before hand and went through any information and explained things, we were given a brochure”. “I can say that we were encouraged to visit often and we were able to ask anything, they were very good”. “Yes, I came here and met everyone”. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported to make decisions about their daily lives and to be independent. Individual care plans reflect the needs of residents, who are protected by clear risk assessments. EVIDENCE: The care records seen identified the individual care needs of residents and how these were to be met and included any risks and how these were to be minimised. For example, one resident was being supported to use the washing machine and microwave as part of developing their life skills and the risk assessment provided staff with sufficient information to support these activities safely. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 11 Care plans were regularly reviewed and updated as per the changing needs of residents and all plans documented resident’s involvement in this process. One resident said: “Yes, I have a plan that is for me”. Policies and procedures promoting and safeguarding residents rights, confidentiality and data protection is in place and providing guidance to staff. Residents said that they were treated well by staff and able to make decisions regarding their day-to-day lives. Comments included: “I can choose what I do”. “I do what I want and the staff tell me too”. “We agree what I’m going to do but I decide”. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Resident’s rights are respected and they are supported to follow their chosen lifestyle although improvements are needed to more fully meet resident’s recreational needs within the community. Resident’s users enjoy the homes provision of meals although they must be afforded choice at each mealtime. EVIDENCE: Residents are able to attend a variety of clubs and leisure facilities although more recently visits to external recreational facilities had been sporadic. Senior staff confirmed that the budget for recreational activities had recently been altered resulting in the home staff having to request individual funding for all activities prior to any event taking place. Senior staff said that this system was not working well as this prevented residents getting involved in activities at short notice. Also, staff members said that they now had to pay Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 13 for themselves if taking residents out to meet their recreational needs. The inspector spoke with the responsible individual regarding this who agreed to look further into the matter. Residents are notified of their rights in formats that are user friendly where possible and staff are provided with information as to how resident’s rights and choices are to be promoted and met. Care records document the important people in resident’s lives and where contact is maintained. The residents spoken with said they enjoyed the meals provided although there was no food choice during weekday lunchtimes and no cooked breakfasts were available, which was further confirmed by the staff spoken with. Residents are consulted about menus, and effort is made to use fresh produce and low sugar, where possible. Residents in the adjacent semi-independent bungalow are responsible for their own individual shopping, menu planning and cooking, with assistance from staff. Residents and their representatives said: “I like the food, yes”. “Its alright, yes you have enough to eat”. “There’s not always a choice”. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health care needs of residents are met and their wishes regarding the care they receive is promoted. EVIDENCE: Residents are supported to administer their own medicines if they are assessed as able. Policies and procedures regarding the administration of medicines provide guidance to staff whom receive some in house awareness training regarding this subject matter although more extensive training is being arranged. Medication administration records are satisfactory. Care records instruct staff as to individual residents care needs and preferences and residents are involved in the devising and updating of their own plans where this is possible. Individual preferences or instructions regarding bereavement are documented. Residents emotional, health and medical needs and input were identified within the care plans seen. For example, the records of one resident receiving support from district nursing staff provided clear guidance to staff. Also, the Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 15 care records of one resident prone to becoming agitated and aggressive provided guidance for staff to minimise potentially difficult situations. The resident involved spoke about this and said: “I get very angry and upset by things and the staff talk with me and help me with this but it’s difficult”. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Systems are in place for residents to raise concerns or complaints and the home staff are made aware as to how to protect residents from the risk of abuse or harm. EVIDENCE: There have been no formal complaints and two safeguarding adult referrals since the last inspection, which have now been closed. The residents and representatives spoken with said they were aware of complaint policies and procedures and most felt able to express any views to staff and that they would be appropriately acted upon. Comments included: “I feel that I could complain if I needed to”. “I have raised matters before and they were not really listen to”. “If I complain then they sit and talk things through, they will listen”. “I’ve had no need to complain but from how they are I do feel they would listen”. “If you complain they will help”. The complaints procedure is displayed in the home and is being included in the updated service users guide. Staff have received some training on how to safeguard vulnerable adults from abuse, of which policies and procedures are in place and the staff spoken with were aware of the correct action to be taken in the event of an issue of abuse being identified. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 17 Risk assessments are undertaken, specific to residents care needs, which are reviewed and updated as necessary. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. A comfortable environment is provided for residents overall, although there is still insufficient communal space in the main building, and some minor maintenance issues remain outstanding. EVIDENCE: Three residents showed the Inspector their rooms during the visit. Other communal areas were viewed along with one room in the “bungalow” part of the home. The majority of areas seen were clean, with hygiene practice followed by the care team to minimise risks to residents although one service users representative said that the residents bedroom had not been vacuumed for approximately one week, which was confirmed by staff. It is acknowledged that some residents may refuse assistance although staff should pay extra consideration to facilitating overall standards of cleanliness. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 19 A rolling programme of redecoration is in place and whilst the bedrooms seen were recently painted the overall décor of many areas is basic and further effort should be made to create a homely environment for residents. Previous inspections have highlighted insufficient communal space in the main building, following the conversion of the office. This matter remains outstanding. Some previously identified maintenance issues also remain outstanding. For example, the kitchen in The Beeches requires attention, as some of the units are showing signs of wear and tear. The dining room tables in the main building require replacement. The tops of two of them are loose, and one is sloping. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are well trained, and supported, and recruitment processes are robust to protect residents. EVIDENCE: The staff files inspected evidenced that adequate recruitment policies and procedures are in place prior to staff commencing work at the home. These include the promotion of equal opportunities. Newly recruited staff attend induction training upon commencing work at the home although some records of recently inducted staff were not available during the visit. The staff members spoken with were satisfied with the recruitment process and confirmed that they had received induction and training appropriate for the roles. A training plan is in place and any outstanding training needs are identified and provided for. Staff meetings are held monthly, of which records are maintained and staff receive formal supervision. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 21 The residents representatives spoken with said that they were satisfied overall with standards of care overall but that the home was not always well staffed or kept clean and tidy. The manager agreed to progress this matter. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s rights are promoted and safeguarded. Systems are in place to measure the quality and satisfaction levels of the services provided. The health and safety of the home is adequately maintained. EVIDENCE: Regular health and safety audits are undertaken, of which records are maintained. Weekly environment audits are undertaken and fire safety systems are procedures are in place. The residents and representatives spoken with were satisfied overall with the management of the home. Comments included: “My loved one has not been here long, but you can ask the staff or manager anything, they are approachable”. “I have found them to be good, they listen to what you say Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 23 and the care seems good”. “I have spoken with staff before but they don’t seem to listen”. “I like the staff and they all want to help me”. “The staff are all good to me”. Policies and procedures safeguarding resident’s rights are in place and staff receive guidance regarding these. Residents meetings are regularly held although quality satisfaction questionnaires have not recently been undertaken. The staff members spoken with were satisfied with the management of the home and said they felt able to discuss any views and that these would be respected. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 25 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 YA1 Regulation 16.2 4 Requirement Sufficient activities, which are regular and appropriate to the needs and wishes of all residents, must be provided and documented in line with the homes statement of purpose. Residents must be afforded a choice of foods at each mealtime. Confirm must be received regarding what action is being taken to ensure that adequate communal space is provided. (This requirement is outstanding from 6th April 2004). The registered person must confirmation is required that that the maintenance issues identified are addressed. All parts of the home must be clean. Timescale for action 01/11/07 2. 3. YA17 YA24 16.2 23 (2) (a) 01/11/07 01/11/07 4. YA24 23 (2) (b) 01/11/07 5. YA30 23 (2) (d) 01/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 26 No. Refer to Standard Good Practice Recommendations Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashridge DS0000034818.V339679.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!