Inspection on 06/10/08 for Ashtead Cottage

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good service.

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

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Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashtead Cottage 165 Barnett Wood Lane Ashtead Surrey KT21 2LP two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisa Johnson Date: 0 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Ashtead Cottage 165 Barnett Wood Lane Ashtead Surrey KT21 2LP 01372271792 02086421202 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Bhye Mahmood Shamtally Name of registered manager (if applicable) Mrs Maria Melodina V.Non Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 0 care home 9 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). The maximum number of service users to be accommodated is 9. Date of last inspection A bit about the care home Ashtead Cottage provides care and accommodation to nine adults with mild to moderate learning difficulties. The accommodation offered is in a detached property in a residential area of Ashtead. The accommodation offers individual bedrooms over two floors, a dining room, kitchen and two lounge areas. The home has a bathroom on the first floor and some individual bedrooms have en-suite facilities. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The inspector arrived at the home at nine Oclock in the morning. The home did not know that we were coming to visit. Before this visit the manager sent us information about the home to tell us how well the outcomes for people living there are being met. People living in the home sent us some comment cards to tell us how well they think the home is supporting them. During this visit we looked around the home We spoke to three people who live in the home We spoke to the manager and the people who own the home We looked at some peoples care plans We looked at some of the homes records that they have to keep such as medicine records, staff training records and policies and procedures What the care home does well Three people spoken with during this visit said that were happy living in the home and that staff were nice. Each person has a care plan, which has been discussed with them and includes information about peoples likes and dislikes. House meetings are held where people living in the home can talk about things that are important to them. Each person has their own bedroom, which contained lots of their favourite possessions. People are supported to access lots of activities and social events. One person said that they go to church on Sunday and they go to the cinema. Another person said that they like to go shopping People living in the home take part in activities in the home like doing the washing up, cleaning and doing their laundry What has got better from the last inspection What the care home could do better The person that owns the home must write a report each month about their visit to the home Some of the radiators in the home did not have covers on them which could be dangerous when they are hot If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Lisa Johnson 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Prospective people considering the home as a place to live are provided with the information they that need to decide about the suitability of the home as a place to live . Peoples needs are assessed prior to moving into the home ensuring that the home is able to meet their needs. Evidence: The home provides a statement of purpose and service user guide which has been reviewed and updated. Each person is provided a copy which were seen in peoples bedrooms. Since our previous visit there have been no admissions to the home. There is currently four vacancies and the home is currently receiving referrals. The manager stated that they had been carrying out some assessments, which are conducted when visiting the person. A pre- admission assessment was viewed for one person which was detailed and comprehensive. The manager also obtains an assessment from the care manager. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are provided with a person centered care plan which reflects their needs and goals. People are supported to make decisions about their lives and they are supported to take risks as part of an independent lifestyle. Evidence: Each person has a care plan in place, which is based on assessment including the community care assessment and covers personal, health, emotional and social needs. During this visit three individual care plans were viewed which were person centered in their approach. These were supported by by pen portraits, profiles and life pictures. Care plans are reviewed annually and six monthly with the involvement of people living in the service who had signed their care plan to confirm their agreement. Peoples individual goals and objectives were recorded and daily records sampled were detailed and reflected peoples agreed goals. We were informed that the home will be introducing a new care planning system. The home holds regular consultation meetings with people to enable them to make decisions about their lives. The manager showed us some pointer cards that they use in discussion with people to assist them with communication. Each person is asked who they wish to allow to share their documents with and gain their agreement. People are encouraged to be independent in managing their finances and where people require support this is recorded in their care plan. Individual risk assessments and management systems are in place,which are explained to people. Risk assessments sampled included bathing, road safety , community access and for behavior which may challenge. During this visit one person was Evidence: observed to be using a walking aid and they require supervision and assistance with the stairs. This was recorded in the care plan and supported by a risk assessment which staff were observe to follow. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are supported to participate in a range of appropriate activities and engage in a range of leisure pursuits which meet with their preferences. People take part in the local community and their rights and responsibilities are protected. The home is able to demonstrate that people are provided with a well balanced and nutritious diet. Evidence: People living in the service are supported to access a wide range of meaningful educational, recreational and social activities. This includes attendance at college, day services, volunteer work and work placements. One person has been undertaking a drama course at college and has been performing in the local theatre. Peoples social activities are considered in their careplan. One persons care plan identified that they enjoy board games. During this visit this person was see participating in this activity with a member of staff. Another person told us that they enjoy going shopping and told us about the holiday that they went on. Other social events include visiting the cinema, Gokarting, horse riding and attending rock concerts. People living in the service maintain links with the local community such as joining trips and local events which meet with their personal interests and preferences including mencap club and pub nights. Staff also assist people to use the library and leisure centres. The home holds a meeting on Thursday nights to discuss activity planning at weekends where people can choose and decide what activities they might wish to attend, which Evidence: includes going to car boot sales, trips out and personal shopping. People are supported to maintain links with their families and friends. People spoken with during this visit told us about their families and friends and one person told us about their friends at the church. Telephones are available for people to maintain contact and they are assisted to make greeting cards for special occasions. Peoples personal relationships are considered in the person centered care plan and are they supported by staff to maintain these relationships. During this visit good interaction was seen between people and staff and people were observed to be moving around the home without restrictions.Staff were seen to be respectful, caring and attentive to people throughout this visit. People are involved in participating in household tasks in the home. During this visit one person was observed doing their laundry and another person said that they hoover their bedroom. Another person told us that they help with the drying up. The home has a weekly menu in place which is drawn up in consultation with people with the support of a menu planning pack which contains pictures. Choices of meals are provided. Information recorded in one persons care plan stated that like like cereal and toast for breakfast, which this person was provided with. Another person said that his favourite meal is shepards pie which he is able to have. People spoken with said that they enjoy their meals. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is able to demonstrate that people living in the service receive personal support in the way they prefer. peoples physical and health need are met and they are protected by the homes medication policies and procedures. Evidence: Peoples health care and personal needs have been identified in their care plan which includes their likes, dislikes and preferences such as favorite meals, activities and preferred ways of receiving medication. The home provides flexible support. At the time of this two people chose to have a lie in which was respected by staff. Each person has a designated key worker and people are enabled to choose their preferred staff to support them such as gender. Care plans clearly identified how personal support is to be provided such as support with showering and bathing. Peoples files sampled contained a health action plan and checklist which clearly identifies when health screen checks are due. One persons care plan identified that they had received an annual health screen check, requires regular visits to the optician and during this visit they were supported to attend a dental appointment. Records were maintained of all health care consultations. The homes medication administration practices were examined. The home uses the Monitored Dose System. The amount of medication received by the home was recorded and records are maintained of disposal. Medication administration cards contained a picture of the person and medication cards had been signed. The medication cupboard is situated in the office and medication was stored safely. Authorization has been obtained from the General Practitioner in respect of homely remedy medication administered in the home. Evidence: Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is able to demonstrate that the views of people are listened to and acted upon and they are protected from abuse Evidence: The home has a complaints procedure in place which was seen on display. This document has been formulated with some pictures to make accessible, although the home is advised to increase the size of the print as this was difficult to read. The home holds regular house meetings where people are supported to raise any concerns or complaints and the home also provides a suggestion box . Two people spoken with were clear in their responses about who they could talk to if they were not happy. Since our previous visit the home has not received any complaints and none have been brought to the attention of the Commission. The home has comprehensive safeguarding vulnerable adults from abuse and whistle blowing procedures in place. The manager provided evidence to us to show that they had obtained the updated local authority policy and procedure and alert advice cards were seen on display on the notice board in the hallway. Staff training records viewed during this visit and discussion with the manager confirmed that staff receive safeguarding vulnerable adults from abuse training. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a comfortable, clean and homely environment, although one health and safety matter needs attention. Evidence: The home is situated in a residential area close to local shops. The home provides a spacious environment which includes two sitting rooms, a dining room and a large kitchen. There is a large accessible garden to the rear of the home. The service provides a homely atmosphere, although some areas of the home look tired and in need of modernizing and redecoration. Discussion with the manager and the new owner confirmed that they are committed to carry out this refurbishment and outlined some of their plans to us. People living in the service have been consulted about the planned refurbishment and their comments and suggestions are considered. we were informed that new fittings have been installed in an en suite shower and new curtains have been fitted. People living in the home have their own bedrooms and some have en suite facilities. One person told as that he is going to have his bedroom redecorated shortly and that he was able to choose his favourite colour and was very happy about the new curtains that had been fitted in his bedroom. Bedrooms viewed during this visit were personalized and some people have television satellite boxes and one person has a computer. During this visit the home was observed to be clean and hygienic. There is a separate laundry facility and cleaning schedules are in place. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The current staffing arrangements in the home meet the needs of people living in the service. People are supported by staff that have the appropriate qualifications and skills and they are protected by robust recruitment procedures. Evidence: During this visit the staff rotas were sampled. people are supported by two members of staff during the day and at night time there is a waking member of staff. The manager also works supernumerary to this during the day time. People living in the home are supported by care staff that hold National Vocational Qualifications (level 2 ) or above. The training records for three members of staff were seen during this visit, which confirmed that they had received statutory training including health and safety, food hygiene, first aid, safeguarding vulnerable adults from abuse and health and safety. Some of this training is in the process of being up dated. We were informed that new staff receive induction training following the Skills for Care core induction standards and staff are provided with the General Social Care Code of Conduct. Information supplied in the AQAA states that the staff team have recently received training in makaton sign language which ensures that they are able to communicate more effectively with one person who has non verbal communication. Further information supplied in the AQAA states that in house training has taken place on challenging behaviour. During this visit we were informed that the company has achieved the Investors in People award and they are making an application to include this service. We were also informed that new information technology system is being set up to assist in updating staff training and development plans. Evidence: There is a recruitment policy in place and the company has a human resource manager who assists with the recruitment and selection procedure. During this visit the personnel files for three members of staff were seen. information seen on these files demonstrated that effective recruitment practices are in place which protect people. This included application forms, two written references, protection of vulnerable adults first checks (POVA) and enhanced criminal record bureau checks (CRB). Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is run by an experienced manager which is run in the best interests of people living there and their health and safety is in the main protected. Evidence: The home has an experienced registered manager in post and is currently completing the Registered Managers Award. The manager was observed to have an open and inclusive approach and was observed to make her accessible to both people living in the service and staff. Since our previous the home has been purchased by new owners and we were informed that they are supportive and wish to make positive changes. The home conducts regular house meetings and written records were viewed. The home has conducted quality assurance feedback surveys to gain the views of people and their families about the care and support provided. We were informed during this visit that these are due to be updated. The company has a quality assurance manager who assists and supports the manager. The manager informed us that the registered providers visit often, however there were no written records available to confirm that monthly quality monitoring monitoring visits are being conducted. The quality assurance manager informed us that a format is in the process of being prepared. The home has a range of policies and procedures which are up to date. The home now has access to a computer to enhance communication. Throughout the AQAA and through discussion with the manager she has identified that further development is needed to ensure that a a range of documents could be improved by making them available in more accessible formats. The homes fire records were sampled and it was seen that regular fire drills and Evidence: equipment checks take place. Records are maintained for monitoring water temperatures and substances hazardous to health were stored appropriately. During a tour of the home it was observed that some areas of the home had radiators without covers on. It is required that a risk assessment is completed and discussed in consultation with the environmental Health department ensuring the well being and safety of people living in the service. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 39 26 The registered person must maintain a written report in the home for the monthly quality monitoring visit. 09/11/2008 This is to ensure that the home is run in the best interests of people living there. 2 42 13 The registered person must ensure that a risk assessment is completed in respect of the uncovered radiators in the home 09/11/2008 This is to ensure the safety and welfare of people is protected. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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