Inspection on 09/05/06 for Ashridge

This inspection was carried out on 9th May 2006.

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 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 Mick Walklin Key Unannounced Inspection 9th May 2006 10:00 Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 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.V293678.R01.S.doc Version 5.1 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.V293678.R01.S.doc Version 5.1 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.V293678.R01.S.doc Version 5.1 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 Date of last inspection 10th March 2003 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. The manager confirmed that the range of fees currently charged is between £392 and £790 per week. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of Ashridge, and through undertaking a visit to the home. The fieldwork visit took place over 7.5 hours. 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. A tour of the premises was conducted with the manager. Other documents connected with the running of the care home were also inspected. What the service does well: What has improved since the last inspection? What they could do better: There is still not enough communal space in the main building, and some minor repairs need to be carried out. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 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. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 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.V293678.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient information available for people considering living at the home, and assessments are thorough, ensuring that support needs are identified. EVIDENCE: The Statement of Purpose provides a range of information for residents, carers and social workers to help them decide if the home can meet the needs of the prospective resident. The manager was dealing with an enquiry regarding a prospective new resident at the time of the inspection. She explained that the person had visited last week, and had said that he wanted to live at the home, and they were waiting for approval of funding. During the visit, he had been assessed by the manager, and a more detailed ‘Personal Assessment’ will be completed prior to admission. Two other people who had moved into the home recently had detailed pre-admission assessment information on file, including a Social Services care plan. All admissions are for an eight-week trial period. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans fully reflect residents needs, and residents are well consulted. EVIDENCE: Care plans contain a comprehensive range of information, which clearly identifies the level of support required by residents. Those residents that were able to, confirmed that they had been involved in the preparation of their care plan, and had discussed the contents with staff. Care plans are signed either by the resident or their representative, and reviewed on a monthly basis. Any risks identified as part of this process generate a risk assessment, which is cross-referenced with the care plan. Residents said that they are well consulted, and able to make decisions and choices relating to their preferred lifestyle. One said, “It’s nice here for me – staff respect my independence”. Regular residents meetings are held, and residents are offered the opportunity to chair the meeting. Holidays, outings Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 10 and household issues are discussed, and a resident explained that a Freeview box had been purchased following suggestions made at a residents meeting, which enables residents to enjoy a wider range of TV programmes. Residents said that they had also been involved in choosing décor and pictures for the home. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents participate in a range of activities, so that residents have an enjoyable and stimulating timetable. Catering arrangements reflect individual choices. EVIDENCE: The previous inspection highlighted issues relating to 1-1 funding for some residents. The manager explained that this was having a negative impact on social opportunities for these residents. The home offers an in-house day provision for 3 people, situated in a building in the grounds, and other residents either have individual support packages or attend external day services. One resident works at a local supermarket, and another has recently lost his job, and is seeking alternative employment. Residents said that they are happy with the level of activities available, and one described how she was looking forward to forthcoming events, including a party at the Gateway Club, and a holiday at Butlins in Skegness. The home has a minibus available for Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 12 outings. Some staff have received training to enable them to deliver the ASDAN curriculum (Award Scheme Development and Accreditation Network Towards Independence), which will enable residents to work towards specific goals relating to independent living skills. Residents in the Beeches are self-catering, and a person living in the semiindependent bungalow stated that they are responsible for their own individual shopping, menu planning and cooking, with assistance from staff. Residents in the main building said that the standards of food had improved since the existing cook took up post, and all residents interviewed were happy with the quality and variety. One said, “we had burgers today, but I don’t like them, so the cook gave me ham”. Residents are consulted about menus, and the cook explained his philosophy of using fresh produce and low sugar. He explained that he has recently gained a silver award under the Boston Borough Council ‘Safer Food – Better Business’ scheme. He is also undertaking a distance-learning course on healthy eating. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported, with good arrangements for meeting residents health needs. EVIDENCE: Residents said that they receive very good support from staff. One said, “Staff help me if I have a problem”, and “the staff are good – they listen and understand”. Another example of good support was given by a resident who had been very upset following three residents passing away. She said that staff had handled the situation very sensitively, and had offered her very good support. Residents have health action plans, which identify any health issues. One person with Downs Syndrome had a care plan which clearly identified any health problems associated with the condition. Visits by health professionals are well recorded. 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 Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 14 GP. A Chiropodist visits the home every 6 weeks and local dentists and opticians are accessed as required. A medication error was reported to the Commission in January. This was investigated, and no further action was necessary. A pharmacy inspection was conducted in March, and prompt action was taken on recommendations. Medication storage was satisfactory, but the administration records relating to one residents ‘as required’ medication were confusing, and it is recommended that the advice of the pharmacist be sought. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for dealing with complaints and adult protection ensure that residents are protected. EVIDENCE: There had been one complaint from a relative since the last inspection, which had been referred to the company for investigation. All residents have a copy of the complaints procedure in their care plans, in written and symbols format, and those interviewed said that they would feel comfortable reporting any concerns to the manager or deputy. All staff interviewed demonstrated a sound knowledge of the adult protection procedures, and their reporting responsibilities. They confirmed that they had received periodic update training, and were aware of the location of policies and procedures. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 16 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 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 good standard of accommodation. Some areas of the main building have been decorated, and residents said that they preferred the new décor, and found the home brighter. Previous inspections have highlighted insufficient communal space in the main building, following the conversion of the office. This matter is still being addressed by the company. Although damp patches to some bedroom ceilings are still present, they have been painted, and investigations into this problem are ongoing. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 17 The following maintenance issues were identified: • • The blinds fitted to the living room patio door in the main building require replacement. 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. The carpet in one bedroom requires replacement. One resident complained that her radiator was faulty, and she could not turn it off, although she had not appeared to report this to staff. The exterior wall and window frame of the dining room requires attention. • • • • Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36. 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: Residents confirmed that there are enough staff to meet their needs. Staff were observed to respond quickly to defuse potential incidents, and respond to residents concerns. For example, one resident was very angry about the mess another resident had made in the kitchen, and staff resolved this promptly. Staff said that they have plenty of time to help residents access local community facilities, and that there are no particular ‘pressure’ times during the course of the day. Staff said that training opportunities are very good, and gave examples of courses that they have attended, which covered both mandatory and specialist subjects. Staff confirmed that they complete the Learning Disabilities Awards Framework, which equips them with the skills and knowledge for working with people with a learning disability. They also confirmed that opportunities for studying towards National Vocational Qualifications. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 19 Staff files provided evidence of thorough recruitment and selection process, and staff said that they are well supported, with supervision being offered ‘every 6-8 weeks’. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and organised, and documentation is of a good standard. Health and safety is well monitored. EVIDENCE: Regular monitoring visits are conducted by the area manager, and a satisfaction survey is currently being undertaken. The area manager, who was present for a part of the inspection, explained that the results of the survey will be evaluated, and an action plan will be devised to address any issues. The home has a Health and Safety Committee, which conduct a quarterly audit. The maintenance person also conducts weekly audits. It was noted that the fire log is incomplete, as fire tests are recorded on the monthly monitoring forms. The window restrictors in residents bedrooms can be unhooked, Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 21 allowing the window to be fully opened, and it is recommended that these be risk assessed on an individual basis. Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 22 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 3 2 3 3 x 4 x 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 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 4 36 3 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 x 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 23 Yes 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 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 the maintenance issues identified are remedied. Timescale for action 31/12/06 2. YA24 23(2)(b) 30/09/06 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 YA20 Good Practice Recommendations It is recommended that the pharmacist be contacted for advice relating to the recording of as required medication on the administration record. It is recommended that the window restrictors fitted to bedroom windows are risk assessed on an individual basis. 2. YA42 Ashridge DS0000034818.V293678.R01.S.doc Version 5.1 Page 24 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.V293678.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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