Inspection on 22/06/05 for Ashring House

This inspection was carried out on 22nd 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

Ashring House 15/08/07

Ashring House 19/09/06

Ashring House 04/01/06

Ashring House 08/09/04

Ashring House 14/04/04

Ashring House 20/01/04

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

CARE HOME ADULTS 18-65 Ashring House Lewes Road Ringmer East Sussex BN8 5ES Lead Inspector James Houston Unannounced 22 June 05 09:00 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. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashring House Address Lewes Road Ringmer East Sussex BN8 5ES 01273 814400 01273 814400 None Ashring House Limited (Beacon Care Holdings Plc) Miss Margaret Ann Goodwin Care Home 6 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) Category(ies) of Learning Disability (LD), Physical Disability (PD), registration, with number 6. of places Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated will be six 2. The residents should be aged under fifty five years on admission 3. All residents will have a learning disability 4. There will be a maximum of two people who may also have a physical disability Date of last inspection 8 September 2004 Brief Description of the Service: Ashring House is a detached single storey house located along the main road in the village of Ringmer. It is a short walk to the village where there are shops and local services and the local community college. It is one of a group of homes owned by Beacon Care Holdings for adults with learning disabilites and physical disabilities who are aged between 18 and 55. Ashring House aims to enable its residents to lead a fulfilling life in which their abilities are promoted and they are empowered. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the twenty second of June 2005. Before the inspection the inspector read records held on the home by the Commission for Social Care Inspection and prepared to inspect those sections of the standards to be covered at that visit. The inspection of the home took 4.9 hours. The inspector made a tour of the entire premises, and met the manager, three staff and four residents. Six residents were living in the home on the day of the inspection. Since the last inspection the home has sought a variation of its registration with the Commission for Social Care Inspection. Four of its six current residents have physical disabilities in addition to their learning disability and the certificate of registration has been amended to take account of this. 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. Ashring House H59-H10 S21034 Ashring House V229744 220605 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 Ashring House H59-H10 S21034 Ashring House V229744 220605 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) 1,3, and 5. The home provides full information to prospective residents and their representatives to inform their decision about coming to live in the home. The home meets the needs of the current resident group. The home has a suitable contract with each resident. EVIDENCE: The home now has a statement of purpose and service users guide which give full information. From discussion with staff and examination of records it is clear that staff individually and collectively have the skills and experience to meet the needs of residents. Observation confirmed that staff are able to communicate with residents. The manager said that half the staff have had Makaton training and the other staff will do so. The manager said that the home would not admit any resident whose needs they could not meet. Each resident has a contract that has been agreed with his or her placing authority. In addition details of the terms and conditions of residence are included in the home’s statement of purpose. Ashring House H59-H10 S21034 Ashring House V229744 220605 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 and 9. Comprehensive care plans and risk assessments are kept and regularly reviewed. EVIDENCE: Good care plans are drawn up. Staff said that they have read them and are familiar with them. Care plans inspected were found to be updated and reviewed regularly. Staff said that they are given guidance on how to write in the daily records. These were inspected and found to be up to date and well kept. A new form of recording is to be implemented shortly. The plans inspected contained thorough risk assessments. Records inspected showed that they are reviewed regularly. Staff confirmed that they use the risk assessments drawn up to assist residents to lead lives that are as full as possible, and that they give training and guidance to residents. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 9 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) 11,14,15 and 17. Residents are enabled to maintain and develop social and communication and living skills. Residents have access to and choose from a range of leisure activities. Visitors to the home are made welcome. Meals and mealtimes promote the health and well being of residents. EVIDENCE: Talking to staff and reading documentation showed that the ethos of the home is to maximise residents’ independence. Staff gave clear instances of how over time the levels of communication and independent living skills of some residents have shown improvement. Staff said that residents’ spiritual needs are identified and met, and that some residents attend a local church, accompanied by staff. Inspection of care plans and the weekly timetable of activities provided evidence that the home enables residents to take part in activities and events of their choice. Almost all the residents went out to the local college on the morning of the inspection, and enjoy a variety of activities there. Staff said that residents like to go on a range of outings and the home has its own people carrier. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 10 Residents enjoy local community activities such as the funfair and fetes. Residents have the opportunity to go on a range of holidays both abroad and in this country. A resident that said he was looking forward to going to Euro Disney by train. Staff said that it is an important part of their role to make welcome residents’ visitors. Staff said that residents are enabled where possible to maintain close links with their family and friends. A resident was visiting their family later that day. The home keeps clear records of food provided and alternatives given. There are currently no religious or cultural diets required, and therapeutic diets are provided for as needed. Residents usually eat in the dining room but this is flexible. Staff said that they give assistance with feeding as needed, and that there are sufficient staff to do so in an unhurried way. The meal served during the inspection was in ample portions and attractively presented. A resident said that they liked the food served. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 11 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) 18,19 and 20. Residents receive personal support in the way they prefer. The home makes effective arrangements to meet the healthcare needs of residents. The systems to manage medication for residents are thorough. EVIDENCE: Staff said that times of getting up and going to bed are flexible, and that guidance and support regarding personal hygiene is provided as required. Residents choose where possible which clothes to wear. The home has a key worker system and key-workers spoken to were able to outline in detail how residents are supported in maximising their independence and control over their lives. Records inspected showed that close links with a range of health professionalseg GPs and hospital specialists, community nurses, dentists, and opticians- are maintained. Records are kept of appointments. Staff were confident that the healthcare needs of resident are being met. Residents are registered with a local GP and staff said that they take residents to the surgery as needed. Medicines administered to residents are securely kept, and the record of medicines administered was found to be fully recorded. No controlled drugs are held at present, and no residents currently self-administer. Only senior staff hand out medications and they confirmed that they had had suitable training. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 12 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) 22 and 23. The home has a clear complaints procedure. The home has a suitable adult protection and whistle-blowing policy that should protect residents in the event of abuse or allegations of abuse. EVIDENCE: The home has a clear complaints procedure that is displayed in text and pictorial versions in the home’s hall. The home has a complaints log that showed that the home has had no complaints made to it in the last year. The home has a system for dealing with any complaints made. No complaints have been made to the Commission for Social Care Inspection concerning the running of the home. The home has adult protection and whistle-blowing procedures of which staff said that they are aware. Staff said that they have received relevant training and records inspected confirmed this. The manager is aware of the need to report any unsuitable staff to the Protection of Vulnerable Adults list. Monies are held on behalf of residents and a balance checked at random tallied with the record of monies held. Receipts are kept of transactions made, and the records of several residents are sent monthly to their representatives. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 13 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 and 28. The home offers a congenial environment for residents. Communal areas and bedrooms are well maintained and furnished. EVIDENCE: The home is close to local amenities and transport and is in keeping with the neighbourhood. The premises are suitable for resident’s needs., ie a bungalow that offers level access throughout. There is a large communal space comprising a lounge with conservatory and a kitchen/dining room. The premises are safe, bright and free from odours. Since the last inspection the carpets in the communal areas have been replaced, new lino has been laid in the conservatory and new bathroom has been fitted. Residents’ rooms are personalised and contain residents’ personal possessions. Staff said that residents have had a say in the decoration and themes of their rooms, and a resident confirmed this. All rooms are lockable but residents do not at present hold keys. The home has sufficiently and suitably equipped bathroom and toilet facilities to meet the needs of residents. The home has a good-sized garden that is well kept, and had put up a canvas gazebo, under which a resident was enjoying sitting in the sun. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 14 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) 32,33,34 and 36. Staff are competent. The recommended level of qualification of 50 of staff having NVQ level2 by 2005 has been met. Recruitment procedures are robust. Staff are regularly supervised to assist them to continue to meet the needs of residents. EVIDENCE: The home has a commitment to training and five out of ten staff now hold NVQ level 2 in care. The home has a staff rota that was inspected. Observation and discussion with the manager and residents showed that sufficient staff were on duty in the home during the inspection to meet the needs of residents. Good interaction between residents and staff was observed. Staff said that there had been considerable turnover in the staff group in the past, but the group is now stable, with little turnover and sickness and no use of agency staff. They said that regular staff meetings are held and the minutes of the most recent meeting were made available to the inspector. Staff said that the manager is approachable and open in style. The manager said that all staff left in charge are aged at least 21. She said that she lives locally and is on call to her staff, and that senior staff from the provider are also on call to them if needed. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 15 The recruitment files of two recently appointed staff were inspected. They were found to contain all the required paperwork. Staff said that they are given job descriptions and contracts of employment. Records inspected confirmed this. Staff said that they are supervised regularly and records inspected confirmed this. The manager said that she has training in supervising and is due to have refresher training in this later this year. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 16 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) 40,41 and 43. Procedures are thorough and comprehensive. Records are generally well kept. The provider must ensure that their representative makes monthly visits to the home. Management systems are good. EVIDENCE: The home’s policies and procedures manual is reviewed regularly by the manager and dated and signed. Staff said that they are aware of its contents and sign to say that they have read them. Those records inspected were generally well kept. Records are securely stored. Residents are able to see their records, and their families have exercised the right to do so. The home’s provider has visited the home regularly since the last inspection to assess and report upon its progress, but this has been at much less than the required monthly frequency. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 17 The home has a suitable current certificate of insurance that is displayed in the home. Records of transactions are kept. The manager said that she considered that staff are clear as who is responsible for what within the home, and about the role of the home’s external management. Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 18 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 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 x x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashring House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 2 x 3 H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 19 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. Standard 41 Regulation 26(2) &17.2 & Sch 4.5 Requirement Make at least monthly unannounced visits to the home and leave a copy of the report upon the visit in the home avaiable for inspection and send a copy to the Commission for social Care Inspection. Timescale for action 30/6/05 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. Refer to Standard Good Practice Recommendations Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Ashring House H59-H10 S21034 Ashring House V229744 220605 Stage 4.doc Version 1.30 Page 21 - 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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