Inspection on 02/05/06 for Ashurst House

This inspection was carried out on 2nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 28 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashurst House 04/11/08

Ashurst House 07/11/06

Ashurst House 01/08/05

Ashurst House 24/06/05

Ashurst House 04/02/05

Ashurst House 07/09/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ashurst House 9 Briton Road Faversham Kent ME13 8QH Lead Inspector Sarah Montgomery Key Unannounced Inspection 2nd June 2006 1:15 Ashurst House DS0000057495.V292447.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 Ashurst House DS0000057495.V292447.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. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashurst House Address 9 Briton Road Faversham Kent ME13 8QH 01795 590022 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) Ashurst House Limited Mrs Rachel Anne Harris Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Manager to have completed NVQ 4 in management and care by 2005 24th June 2005 Date of last inspection Brief Description of the Service: Ashurst house is a large detached property in a residential road of Faversham. The property has been converted for its present use. The home is owned and run by the company Allied Care Ltd who are based in Surrey. The home is registered to provide personal care and support to up to eight adults aged 1865 years who have a learning disability. There are currently three Service Users living at the home. Accommodation is set over two floors. Stairs access the first floor. All rooms are for single occupancy and have en suite toilet facilities. Some rooms have en suite bathrooms and showers. All bedrooms are fitted with locks and have a television aerial point. There is a large lounge, separate dining room and kitchen. There is a second small lounge on the first floor. There is a small garden to the rear of the property. There is limited parking to the side of the property. The home is within walking distance of the railway station and bus stops. Local shops and facilities can be easily accessed. Weekly fees are £1100 - £1250. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Friday 2nd June 2006 between the hours of 1.15pm and 6.15pm. The inspector spent some time speaking with the manager and reading through documents to assess whether requirements made at the previous inspection had been satisfactorily addressed. The inspector also spoke with service users and members of staff. Evidence gathered during the inspection indicates that previous requirements have not been addressed and that the home is failing to meet national minimum standards. The evidence further suggests that service users are at risk from harm due to their needs not being assessed and by the absence of competent staff. What the service does well: What has improved since the last inspection? What they could do better: The Commission has serious concerns about this service, and are minded to take enforcement action. All requirements from three previous inspections remain unmet. Evidence obtained from the inspection demonstrates that service users needs are not being met, and that they are at risk from harm and neglect. Service users do not have care plans, are not assessed prior to Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 6 admission, are not supported to lead valued and fulfilling lives, and their healthcare needs and emotional needs cannot be met as they are unknown by the staff team. Service users are not protected from harm, either in the community, from other service users, or by the homes recruitment practices. Little evidence could be found that the staff team are competent. Leadership and management of the home is very poor. Staff are not supported or guided. Service users are left to their own devices. Senior management at Allied Care have failed to address previous requirements and have failed to recognise the current crisis in this service. 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. Ashurst House DS0000057495.V292447.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 Ashurst House DS0000057495.V292447.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, 3 and 4. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are unable to make an informed choice about where to live. Service user care may be compromised due to insufficient assessment of needs and skills. Service users cannot be sure that the home they choose will meet their needs and aspirations. EVIDENCE: The service user guide and statement of purpose were inspected. Shortfalls were noted in both documents, with neither being considered appropriate either in content or language used. On page one of the Service user guide it is stated that ‘Ashurst House is registered to home up to 8 service users’. This use of language is considered inappropriate. The service user guide then says ‘we aim to provide a homely a welcoming feel at Ashurst House’, but then later states that service users cannot use the phone during business hours. The service user guide does not provide clarity to prospective service users and their representatives with regard to the stated aims of the home, or who may live there. Both documents state; ‘we aim to provide a homely and welcoming feel to adults of all ages. We are able to offer support to all ages because of our bedrooms on the ground floor, particularly for those who need Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 9 a little help with getting about and allows us to emulate a true family environment covering the generations’. The statement of purpose describes a service which service users are supported by a comprehensive care planning system. The inspection process evidenced that service users do not have care plans. The statement of purpose also describes an assessment process prior to admission. Two service users files were inspected. Neither file contained any assessment documentation. Nor did they contain any care plans. The home is failing to identify service users needs. Staff informed the inspector that they are ‘guessing’ the support needs of service users. Service users feel let down by the home’s lack of input into their care. One service user told the inspector ‘there is nothing to do. There is no one to help you do anything. Me being here slows me down. There is not enough staff and no one to help you cook or do laundry’. Information gathered from conversations with the Manager and a service user evidenced shortfalls in ensuring that service users are provided with enough opportunity to visit and ‘test drive’ the home. No overnight stays are offered, nor are prospective service users invited to stay for a meal. Both the manager and service user described a ‘quick look around’ prior to admission. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users’ assessed and changing needs are not reflected in their care plans. Service users cannot be confident they will be assisted to make decisions about their lives or be consulted on aspects of life in the home. Service users cannot be sure that the risks they take as part of an independent lifestyle are acceptable, safe or appropriate. EVIDENCE: Two service user files were inspected. Neither contained care plans. One service user had moved to the home in February this year. He had moved from another Allied Care Home. The manager gave the reasons for the move as ‘he needed a new start’. The service user was described by the manager as ‘very vulnerable’ and needing support in social skills and independent living skills. I questioned the manager as to how the home was supporting the service user, to which he replied ‘we just make sure he’s okay’. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 11 The second service user had also moved from another Allied Care Home. The manager stated the reason for the move as twofold; to recuperate from a broken knee, and to provide a safe environment, as the broken knee was the result of an assault from a service user in the previous home. The inspector questioned the manager as to how the home was supporting the service user, to which he replied ‘she is only here for respite until her knee is better. We are looking after her’. The inspector questioned the manager as to why no care plans were in place for service users. He replied ‘ I don’t know. I thought they would be in place’. The manager informed the inspector that keyworkers (all team leaders) are responsible for care planning. The inspector enquired what monitoring systems are in place to ensure keyworkers have completed care plans. He informed the inspector that he does not check. He assumes that care plans are in place. Two members of staff were on duty. Both were spoken with individually regarding how service users needs are met. One member of staff was not confident or competent in speaking English, and could not answer any questions relating to care or support provided. The only answer given to the inspector was ‘ I am taking care of the patients. (Service user) he likes coffee. He (service user) is nice to me’. The other member of staff was able to answer questions regarding individual service users support needs, informing the inspector that the three service users living at the home all had complex and differing needs which could not be met by the current staff team due to insufficient staffing and staff that were not competent. Risk assessments were on file. However, the validity of the risk assessments could not be judged as no care plans or assessments were available for crossreferencing. Conversations with staff and a service user indicated that the service user received little or no support from the home, either in house or community based. When questioned about risk assessing home and community activities, the manager stated that ‘he likes to be independent, we can’t stop him’. I reminded the manager that he described the service user as ‘vulnerable’, to which he replied ‘I know, but it’s his choice’. No evidence was found to suggest service users are consulted about life in the home. Conversations with staff and service users, and reading of daily notes, indicated that service users are not supported to make decisions about their lives. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 16 and 17. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are not offered opportunities for personal development. Service users do not receive appropriate support to enable them to be part of the local community. Service users are not offered a healthy diet. EVIDENCE: The home could provide no documents to evidence that service users are receiving support in lifestyle choices. Several times during the inspection staff remarked to the inspector about a service user who they had identified as being suitable for moving on to a flat of his own. No assessment exists for this service user. No care plans exist. When asked what the home was doing to support the service user, particularly in gaining independent living skills, the staff and the service user said that no support was provided. When asked what level of independence does the service user have at present, the staff did not know. The inspector enquired as to how an opinion had been formed in the Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 13 staff group about the service user moving to independence. The inspector was informed ‘because he wants to’. The inspector was informed that the oven had not worked for over a month and that ‘we are living on take-aways’. The manager did not know when the cooker would be fixed, and appeared unconcerned. The inspector informed the manager that the cooker must either be fixed or replaced within two days. Service users were not receiving a healthy diet, and that this ongoing situation was unsatisfactory and detrimental to the health of the service users. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot be confident they will receive support in the way they prefer and require, or that their physical and emotional health needs will be met. Service users cannot be sure they are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: In inspecting this standard, the inspector asked to look at the following documentation; individual care plans and assessments on personal support, and physical and emotional needs, and the home’s policies and procedures for dealing with medicines. Two service users were being ‘case tracked’ throughout the inspection process. This home did not have any assessments or care plans in place for either service user regarding how the service user’s needs are to be met with respect to their health and welfare. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 15 This is of serious concern. One service user was admitted to the home on the 23rd May with a broken knee. This service user has additional physical disabilities, communication problems, and has some behaviours, which may challenge. The service user moved from another Allied care home. No assessment was completed prior to the move, or since. The service user has not left her bed since the day of arrival and receives little if any stimulation. She has no interaction with her peers. Staff informed the inspector they had to ‘guess when doing moving and handling’. The manager was not sure whether staff had received training in moving and handling, and could not provide any evidence that they had. The home had not acquired any specialist equipment for the service user, i.e.; a wheelchair. They had not sought advice from a community nurse. The manager and staff were unaware of proactive techniques to avoid pressure areas. On inspecting the medication file and service users MARS sheets, it became clear that the service user described above was taking a large amount of different types of medication. In the absence of any written information on the service user, the inspector asked the manager why the service user was taking Tegretol. He replied ‘I think it’s for hayfever’. The inspector and manager went through the list of all medications the service user is taking. He did not know why any had been prescribed, what they were for, or what the potential side effects could be. The inspector requested that the manager seeks advice as a matter of urgency regarding the medication service users in the home are taking. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot be sure that their views will be listened to or acted upon. Service users are not protected from abuse, neglect or self-harm. EVIDENCE: The inspector had a conversation with a service user about how to make a complaint. He said he would speak to a team leader or the manager. The service user then went on to list a series of concerns he had raised with management and other staff, and added that there doesn’t seem a lot of point in raising issues because nothing ever changes. Concerns raised by the service user are as follows: 1. 2. 3. 4. Being asked to restrain a service user. Feeling scared of another service user. Not feeling protected from the service user he is scared of. Feeling isolated because staff cannot go out with him to support him with leisure activities because they are too busy. 5. Feeling that he isn’t being supported to learn or maintain skills; ‘there is not enough staff; there is no one to help you cook or do laundry. 6. Wondering why he is there because ‘I have nothing in common with the other service users and I just do my own thing because staff are to busy to be with me’. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 17 A staff member confirmed that the service user prior to the inspection has aired all the above concerns. Service users are not being protected from harm, nor are they being listened to. All three service users at the home have high support needs. No evidence could be found to demonstrate the home has knowledge of these support needs, or that they are supporting service users in a meaningful way. This failure to address service users needs in a planned way indicates that service users are at risk from harm and neglect. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 19 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, 32, 33, 34 and 36. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are not supported by a competent or effective staff team. Service users are not protected by the home’s recruitment policy and practices. Service users do not benefit from being cared for by well supported or supervised staff. EVIDENCE: Staffing at the home remains inadequate and a cause for significant concern. Staff continue to work excessive hours, often being on shift in the home for four days in a row. The inspector was informed this is the normal and accepted working pattern. Requirements from previous inspections to cease this practice have not been addressed. A member of support staff was spoken with during the inspection. Her spoken English was very poor. She could not demonstrate any knowledge of service users needs, and told the inspector that her role is to ‘look after patients’. She could not answer basic questions on how she supports service users, or what support she receives. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 20 A team leader was also spoken with. She demonstrated competence in understanding her role and in the needs of the service users. She accepted that the home is insufficiently staffed and does not have an adequate number of skilled and competent staff. Staff receive regular supervision from the manager. However, the inspector questions the value of current supervision practice as the manager stated it is not goal orientated, nor does he monitor whether staff are fulfilling their responsibilities. The inspector looked at a supervision record of one staff member. In this the manager had written ‘an exemplary staff member’. The manager also informed the inspector that this staff member was responsible for keyworking and care planning for a service user. No evidence could be found of any care planning. The inspector asked the manager if service users are discussed during supervision, particularly in relation to meeting their support needs. The manager stated that service users needs are not discussed, and supervision concentrates on the support needs of staff. Staff files were inspected. One file contained no application form, no CRB, no references, no indication of an interview or any interview notes. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 21 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 and 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is not well run. Service users cannot be confident that their views underpin monitoring of the home. Service users’ health, safety and welfare is not promoted or protected. EVIDENCE: Evidence gathered during the inspection demonstrates that the home is failing to meet the needs of service users, failing to achieve national minimum standards, and is not well run. Service users are not assessed prior to admission, they do not have care plans, their health needs are unknown, opportunities for activities are scarce, and they are at risk from harm of neglect and at further risk by staff not being aware of their assessed needs. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 22 The inspector recognises that although care staff are not working in a good practice environment, they are working hard. However, this does not compensate for the failure of management to address previous serious concerns and requirements, and for the service users to be living in a home that is neglecting to care for them appropriately. The manager stated that regular Regulation 26 visits take place at the home. The Commission is concerned that senior managers carrying out these visits have failed to notice the poor quality of care service users are receiving. Throughout the inspection the manager did not demonstrate any competence in either running a home, or in leadership skills. He could not answer any questions regarding absence of documents (care plans, assessments) and said that it was either the responsibility of the team leaders or of his line management. When asked what his responsibilities were, he was unsure and could not answer. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 23 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 1 2 1 3 1 4 1 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 1 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 1 32 1 33 1 34 1 35 X 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 1 1 1 X LIFESTYLES Standard No Score 11 X 12 1 13 1 14 X 15 X 16 1 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 1 1 X 1 1 1 X X 1 x Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5 Requirement The Registered Person must produce a suitably detailed Service User Guide. A copy should be given to Service Users and a copy sent to the Commission. This remains unmet. The Registered Person must develop an individual contract of terms and conditions of residency with each Service User. Not inspected at this visit. The Registered Person must ensure that any restrictions on freedom and choices made in the best interests of Service Users are detailed in Service User plans. This remains not met. The Registered Person must ensure that behavioural support guidelines are in place where necessary, based on current good practice. Guidelines should be authorised and agreed with the Service User. Staff must be competent when using any physical intervention techniques. This remains unmet. Incidents detrimental to the health and safety of Service DS0000057495.V292447.R01.S.doc Timescale for action 21/07/06 2. YA5 5 03/06/06 3. YA6 12 30/06/06 4. YA23 13(7) 30/06/06 5. YA23 37 30/06/06 Ashurst House Version 5.1 Page 25 6. YA14 16(2)m 7. YA20 13(2) 8. YA20 13(2) 9. YA20 13(2) 10. YA42 12 11. YA34 19 12. YA33 19(5) Users including any use of restraint must be reported to the Commission in writing within 24 hours. This remains not met. The Registered Person must ensure that staff enable Service Users to find and keep appropriate jobs or to continue their education and training. This remains unmet. The Registered Person must ensure that Service Users control and administer their own medication within a risk management strategy. Service Users consent to medication must be recorded. Not inspected at this visit. The Registered Person must ensure that there is a record of staff competency appraisals relating to medication administration including the administration of rectal medicines. Not inspected at this visit. The Registered Person must ensure that all medication is administered in line with the Royal Pharmaceutical Society Guidelines. This remains unmet. Competency appraisals for all staff relating to fire safety must be carried out. All fire equipment at the home must be checked at suitable intervals. Not inspected at this visit. The Registered Person must audit staff files to ensure all documents required under Schedule 2 of the Care Homes Regulations are obtained in respect of each member of staff. This remains unmet. Staff must have the suitable skills for the job including communication skills. This remains unmet. DS0000057495.V292447.R01.S.doc 30/06/06 03/06/06 03/06/06 30/06/06 03/06/06 30/06/06 30/06/06 Ashurst House Version 5.1 Page 26 13. YA2 14(1)(a) 14. YA6 15 15. YA9 13(4) 16. YA17 12 17. 18. YA18 YA33 12 18 19. YA43 12 20 YA1 4 21 YA1 4 22 YA13 16(n) No service user should be admitted to the home unless a detailed assessment has been carried out. This remains unmet. All Service users must have a detailed service user plan which is regularly reviewed. This remains unmet. All potential risks to Service users must be assessed and where possible eliminated. This remains unmet. Health needs including nutrition and weight must be monitored and recorded in Service user plans. This remains unmet. Personal care needs must be detailed in Service user plans. This remains unmet. The registered person must ensure that staff are competent to do the job. This remains unmet. The area Manager is to investigate poor practice, lack of communication and lack of monitoring by the Manager and send a report with recommendations to the Commission. Not inspected on this visit. The registered person much ensure the statement of purpose is reflective of the services offered at the home, and that it is written in accessible and respectful language. The registered person must supply a copy of the updated statement of purpose to the Commission. The registered person must ensure that service users are consulted about their social interests and make arrangements to enable service users to engage in local, social and community activities. DS0000057495.V292447.R01.S.doc 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 03/06/06 21/07/06 22/07/06 30/06/06 Ashurst House Version 5.1 Page 27 23 YA17 16(g) 24 YA19 13 25 YA22 22 26 YA33 18(1)(a) 27 YA37 9 28 YA39 24 The registered person must ensure the cooker is repaired or replaced, and that service users are offered a healthy, nutritional and varied diet. The registered person must ensure that the healthcare needs of service users are assessed and recognised, and that procedures are in place to address them. This includes ensuring that service users receive where necessary, treatment, advice and other services from any healthcare professional. The registered person must ensure that the home follows Regulation and their own procedures with regard to service users making complaints or raising concerns. The registered person must ensure that there are sufficient numbers of staff on duty to meet the needs of all service users. The registered person must ensure they are satisfied that the person appointed to manage the home is competent to do so. The registered person must ensure the quality assurance systems in place are robust and truly measure the quality of the services offered at the home. 04/06/06 16/06/06 30/06/06 30/06/06 30/06/06 30/06/06 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 YA37 Good Practice Recommendations The Registered Manager must be qualified to NVQ Level 4 in Care and NVQ Level 4 in Management by 2005. Not DS0000057495.V292447.R01.S.doc Version 5.1 Page 28 Ashurst House 2. 3. YA32 YA7 4. YA24 5. 6. 7. 8 9 YA42 YA29 YA10 YA4 YA8 Applicable at site visit of 02/06/06. 50 of care staff should be qualified to at least NVQ level 2 by 2005. The Registered Person should help Service Users, if they wish, to participate in local independent advocacy/ selfadvocacy groups and /or to find peer support from someone who shares the persons disability, heritage or aspirations. The home should provide separate premises including communal day space, facilities and equipment for Service Users on respite or short stay unless benefits for both groups can be demonstrated. The Registered Person must ensure that the refrigerator is maintained at the correct safe temperature for food storage. Staff and Service Users should be involved in the review and development of policies and procedures, which should be produced in formats suitable for Service Users. All information and records relating to Service users should be held securely. Prospective service users should be able and supported to ‘test drive’ the home prior to making a decision. This includes overnight stays and ‘tea visits’. The registered person ensures that service users are offered opportunities to participate in the day to day running of the home and to contribute to the development and review of policies, procedures and services. Ashurst House DS0000057495.V292447.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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