Inspection on 04/01/06 for Ashring House

This inspection was carried out on 4th January 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 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 22/06/05

Ashring House 08/09/04

Ashring House 14/04/04

Ashring House 20/01/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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Dovedale Court

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 Jon Wheeler Unannounced Inspection 4th January 2006 2:00 Ashring House DS0000021034.V252112.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 Ashring House DS0000021034.V252112.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. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashring House Address Lewes Road Ringmer East Sussex BN8 5ES 01273 814400 01273 814400 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) Ashring House Limited (Beacon Care Holdings Plc) Miss Margaret Ann Goodwin Care Home 6 Category(ies) of Learning disability (4), Physical disability (2) registration, with number of places Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That a maximum of six (6) service users are to be accommodated. That all service users will have a learning disability. That a maximum of four (4) service users may also have a physical disability. That service users will be aged under fifty-five (55) years on admission. 22nd June 2005 Date of last inspection 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, local services and the local community college. It is one of a group of homes owned by Beacon Care Holdings for adults with learning disabilities and physical disabilities who are aged between 18 and 55. Ashring House aims to enable its residents to lead a fulfilling life in which they are empowered to make choices and their abilities and rights are promoted. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection started at 2.0pm and lasted for just over three hours. The aim of the inspection was to monitor the services provided. Those key standards not referred to in this report were assessed at the inspection of 22 June 2005. The inspection involved talking to the manager, three members of staff and meeting five of the service users. Because of their learning disabilities, the service users were not able to clearly communicate their views about the home. However, service users and staff were observed working together. The process also included reading care plans, policies and records; checking the administration and recording of medication and a brief tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: The service could access advocacy support where service users do not have contact with their family. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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 Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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): 2. The service has a comprehensive pre-admissions policy and process, which enables the service to identify the needs of prospective service users. EVIDENCE: Whilst there have been no new admissions for over two and a half years, the manager was able to describe in detail the policy and procedure for the admission of a new service user. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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, 8, 9. Support plans clearly reflect the preferences, needs and support guidelines for each individual service user. Service users are consulted about issues affecting the running of the home and are enabled to take risks and make decisions about all aspects of their lives. EVIDENCE: The care plans contained a wide range of information, detailing the needs, likes and dislikes of the service users and clear support guidelines for staff to follow. There was documentary evidence that the care plans had been regularly reviewed and updated top reflect any changes in needs. The ethos of the home is to enable service users to make choices, wherever possible about all aspects of their lives. Service users are supported to choose their clothes, food and the activities they do. Where some service users are not able to make a clear informed choice, staff use their experience and knowledge of the individual to gauge their likes, dislikes and if they are content. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 10 There was documentary evidence that service users have set goals to enable them to take part in tasks in the home, including cleaning their rooms, helping with their laundry and some cooking. There was documentary evidence in the care plans that risk assessments in place, relating to a range of activities and opportunities within the home and in the community. Risk assessments had been regularly reviewed and updated. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16. Service users are supported to take part in a wide range of activities to lead fulfilling lives and to meet their needs and ensure their personal development. Service users play an active and fulfilling role in the life of their community. They are supported to maintain positive relationships with their families. The ethos of the homes promotes the right of service users to make choices in all aspects of their lives. EVIDENCE: There was evidence to demonstrate that service users are supported to undertake a wide range of education, vocational and leisure activities in the home and in the community. Activities undertaken include a range of college courses, going to pubs and clubs, exercise groups, attending Church and using facilities in the local towns. There was evidence of service users going on annual holidays, which met their needs and preferences. Some service users in the home have regular contact with their family. Where possible, service users are supported by staff to visit their family, whilst others keep in touch by telephone. It was discussed during the inspection, that where Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 12 service users do not have regular contact with their family, the service could access advocacy support for them to enable clear and transparent discussions about the needs and rights of the service user. There is a clear ethos in the home, promoted by the manager, which recognises the rights and choices of the service users, whilst valuing them and encouraging them to play an active role in the community. Staff were observed treating service users with dignity and respect. Staff were seen knocking on bedroom doors before entering. They also were observed interacting directly with service users in a friendly and relaxed manner. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 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): 19, 20. Service users are supported to access a range of health services to meet their physical and emotional health needs. The health and well-being of service users is safe-guarded by robust medication policies and medication being stored, dispensed and recorded appropriately. EVIDENCE: There was documentary evidence that the health and emotional needs of service users are met, by accessing a range of specialist services. All service users are registered with a local General Practitioner. Care plans included detailed information of the support being provided, or the services being accessed to meet the on-going health needs of the service users. Medication is stored securely within the home. There was documentary evidence that staff who dispense medication had received appropriate training. All medication had been recorded accurately. The storage and recording of medication is checked every day to ensure the staff have followed the policies and procedures of the service. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The service has a complaints procedure to enable service users to raise concerns and complaints. They are protected from abuse by well-trained staff who are guided by robust policies and procedures. EVIDENCE: The service has a complaints policy and a complaints book, although no complaints had been received by the home or by the Commission, since the last inspection. All staff had received adult protection training, and were aware of the service’s adult protection policy. Staff spoken with were able to describe the process of alerting, should they be concerned that a potential abuse had occurred, or if they felt one of the service users was at risk. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Service users live in a safe, clean and comfortable environment, which meet their needs and preferences. EVIDENCE: The home provides a relaxed and homely environment, which is generally kept in good decorative order. The home provides sufficient space and facilities to meet the needs of the service users. There is a lounge, conservatory and a large kitchen/dining area. The home was clean, tidy and free from offensive odours. Ashring House DS0000021034.V252112.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): 31, 33, 35, 36. There are well-trained staff, in sufficient numbers, who have a clear understanding of their roles and responsibilities, to enable service users to lead fulfilling lives and to have their care needs met. The staff team are supported with regular supervision and staff meetings to provide consistent care and meet the needs of the service users. EVIDENCE: All staff are given a job description. The staff spoken with were clear about their roles and responsibilities and those of their colleagues. There are generally six staff on shift in the morning and three in the afternoon, although the manager reported that staffing is provided flexibly to meet the needs of the service users. There is one vacancy in the home, which is being recruited to. The manager reported that any vacancies or sickness are covered by the staff team and the service does not currently use agency staff. There was documentary evidence of comprehensive training provided for the staff team. Five of the staff have completed relevant NVQ training, whilst two are in the process of completing courses. Staff reported that they were able to access courses to enable them to develop their skills and to meet the needs of the service users. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 17 There was evidence that staff receive regular supervision, in addition to an annual appraisal. Staff reported that they were well-supervised and supported by the manager and felt able to seek support or advice when they needed it. Ashring House DS0000021034.V252112.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): 37, 38, 39, 42. A skilled and experienced manager provides clear direction and support to enable the staff to provide good quality care to the service users. A range of regular health and safety checks ensure the health and well-being of service users and staff. EVIDENCE: The manager is an experienced and skilled practitioner who promotes a clear ethos and sense of direction for the service. She ensures the service enables service users to develop their choices and exercise their rights, where they are able to do so. Staff reported that the manager is open, approachable and supportive. There was documentary evidence of a range of monitoring systems within the service, including regular monitoring visits on behalf of the Registered Providers. In addition, a quality assurance questionnaire is sent every six months to professionals who have links to the home and relatives of the Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 19 service users to ask their views on the home. Service users have regular reviews which enables them and their relatives to comment on the quality of care provided. Where service users are unable to express a clear view, staff discuss if they think they can offer anything else to improve the care provided. The service has a range of regular checks to ensure the health and safety of service users and staff. There are weekly checks on the fire alarm systems and of the water temperatures. Fridge and freezer temperatures are checked daily. There are also monthly checks on the lighting and the environment. There was documentary evidence of regular fire drills. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashring House Score X 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 x DS0000021034.V252112.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 YA15 Good Practice Recommendations The service access advocacy support for service users who do not have contact with their families. Ashring House DS0000021034.V252112.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office 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 DS0000021034.V252112.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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