Inspection on 07/11/06 for Ashurst House

This inspection was carried out on 7th November 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 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

Ashurst House 04/11/08

Ashurst House 02/05/06

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 7th November 2006 10:30 Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 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.V318294.R01.S.doc Version 5.2 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.V318294.R01.S.doc Version 5.2 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 Vacant. Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2006 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. The statement of purpose and service user guide is kept in the office. All service users have an individual copy of the service user guide. Weekly fees are £1100 - £1250. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on the 7th November 2006. Evidence was gathered from reading documents, talking to staff and management, and observation. 24 standards were inspected. The home has made significant improvements following the inspections in June and July 2006, and has clearly demonstrated a commitment to compliance in meeting national minimum standards. What the service does well: What has improved since the last inspection? The home has improved their approach to pre-assessment, care planning and risk assessment. This has meant a marked improvement in service delivery and has provided learning opportunities for the manager and staff team. Service users have up to date assessments that have informed their care plans. All service users are receiving a service that is tailored to meet their individual needs, encompassing their choices and aspirations. Training needs of staff have been identified. The home developed and implemented a series of training courses relating to meeting the needs of service users and developing staff skills with regard to recording information. A manager has been appointed, and the staff team and rota has been reorganised. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 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.V318294.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their individual needs and aspirations assessed. EVIDENCE: A random inspection conducted in July 2006 evidenced significant improvements to the statement of purpose and service user guide. These documents were not inspected on this occasion. Following inspections in June and July 2006, the home was required to ensure all service users had thorough assessment documentation, which provided not only historical information, but details of current strengths and needs, and an indication of how the service would meet these needs. These assessments have been completed, and paperwork clearly demonstrates that all service users have undergone recent assessment, which has informed the home’s care planning process. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 9 Care plans and risk assessments relate to assessment of need, and service users are receiving a service that supports them to realise their aspirations, to achieve goals, and to maintain and develop skills. Conversation with the home manager evidenced an awareness and a commitment to ensuring any future prospective service users will only be admitted to the home following a detailed multi disciplinary assessment of need, and if the assessment demonstrates suitability to the home as defined by the statement of purpose. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8, 9 and 10 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their assessed and changing needs and personal goals are reflected in their individual plan. Service users are supported to make decisions about their lives. Service users are support to take risks as part of an independent lifestyle. Service users can be confident the information about them is kept securely and that their confidences are kept. EVIDENCE: To assess the above standards, the inspector read through care plans and risk assessments, looked at a sample of notes from residents meetings, inspected individual daily recordings, daily activity sheets, an activity tracking system and spoke with staff. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 11 Care plans for all service users were inspected. It was evident that care plans were generated in response to individual assessment of need, and included personal aspirations. All service users have a daily activity sheet. Activities on these sheets correspond with service users needs and aspirations. Daily recordings evidenced some correlation of the stated activity in relation to actual daily routine, but some gaps were apparent. It was noted that the care planning system in the home encompasses a large amount of documentation. It is recommended that the current systems are condensed into one care plan. This would make the care plans more accessible to service users and the staff team. Risk assessments for service users were inspected. Again, these documents were thorough, and a clear relationship between assessment and risk was evident. Staff and service users have clear information on individual risks, and these are accompanied by management guidelines. Minutes of residents meetings, daily recordings, and activity tracking sheets, all evidence that service users are supported and encouraged to make decisions in their everyday lives. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident of being supported to take part in appropriate activities. Service users are part of the local community. Service users are supported to have appropriate personal, family and sexual relationships. Service users can be confident that their rights are respected and their responsibilities are recognised in their everyday lives. Service users are offered a healthy and balanced diet. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 13 EVIDENCE: The home has made significant improvements in ensuring all service users are supported and have access to appropriate activities. Following a period of re-assessment, each service user has a daily timetable, which is specific to their assessed needs and personal aspirations. The manager has developed detailed written daily guidance/routine notes for both the early and late shifts. These guidelines give clear instructions to staff regarding expectations and their roles within the shift. There are specific instructions regarding structured day care choices for service users. A shift planner supports these guidelines. Individual service users have chosen to participate in a range of activities, both in house and community based. These include; cookery, art and craft, massage, music, shopping, meals out, swimming, horse riding, and walking. One service user has applied to attend a local day centre. It was noted that one service user living at the home has chosen not to participate in any activities. The home has recorded this appropriately. All service users are supported to make friendships outside of the home, and to maintain contact with their family and friends. Discussions with staff, and with service users on a previous inspection, evidenced that the home is pro active in ensuring that relationships are maintained by telephone and by supported visits. Records inspected indicated that service users are made aware of their rights and responsibilities. Wherever possible, service users are supported and encouraged to gain and maintain skills necessary for increased independence. This is evident in the inclusion of service users regarding household chores, laundry and cooking. Menus were inspected. The home records all meals, including the specific choices of service users. The menus viewed evidenced service users were offered a balanced and healthy diet. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18 and 19 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their personal, physical and emotional healthcare needs are met. EVIDENCE: Two care plans relating to service users individual health care needs were inspected. These evidenced a detailed approach to meeting all assessed needs of the service user. Both care plans gave specific instructions regarding the personal wishes of the service user regarding how they receive any personal care. Care plans contain details of all specialist health and nursing input, including specialist behavioural services. The health care plans are considered to be excellent documents, which provide a comprehensive overview of the individual health needs of service users, and act as an indicator of change in health requirements. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be sure their views are listened to and acted upon. Service users are protected from harm. EVIDENCE: On the day of inspection the home did not have a complaints procedure for service users. Discussion with the manager evidenced that services users are encouraged to raise any concerns or complaints they may have. Records viewed (residents meetings) support this. Following the inspection the home developed a complaints procedure. The inspector has reviewed the new procedure which is in pictorial and easy to read format. The procedure provides clear information to service users about how to make a complaint, and names and contact details of who to complain to. The staff team have received training in Adult Protection. In discussion with the inspector, the manager demonstrated awareness of adult protection, and of the policies and protocols necessary to protect service users. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): ENVIRONMENT STANDARDS NOT INSPECTED. EVIDENCE: Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34, 35 and 36 were inspected. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users would benefit from more accurate recording of daily records and handover sheets. Service users can be confident that the staff team are appropriately trained, supported and supervised. Service users are protected by the home’s recruitment policy. Standards 32, 33, 34, 35 and 36 were inspected. EVIDENCE: Discussion with the manager, and inspection of the staff training matrix and staff meeting minutes, all evidenced a drive by the management of the home towards increased competency of the staff team. This has been achieved by a concentrated training period, close supervision, and clear guidance regarding working practice. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 18 The manager stated that staff team are working confidently and competently with the service user group, and a greater understanding of support needs has lead to positive outcomes for service users. Improvements were noted in daily recordings. However, inspection of shift planners evidenced that they are rarely filled in appropriately. Information regarding why activities have not occurred was absent from most daily recordings inspected. Similarly, there was sparse recorded evidence regarding choices or decisions made by service users. Staff files were inspected and found contain all information necessary for the protection of service users and documents which evidenced a thorough recruitment process adhering to equal opportunities. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home, which is well run. Service users benefit from the leadership and management of the home. Service users can be confident that their views underpin self-monitoring, review and development by the home. Service users can be confident that their health, welfare and safety are promoted and protected. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager demonstrated throughout the inspection process an understanding of the past difficulties that had faced Ashurst House. HE presented to the inspector solutions and strategies that had served to turn around the home to ensure all service users received a service that were appropriate to their needs and gave them a good quality of life. Additionally, he had created working partnerships with staff and senior management to ensure that all staff are working and communicating effectively. It was clear throughout the inspection that the home was organised and managed in a way which supported and encouraged the views of service users, and that these views shaped the day to day working of the home, and affected the direction of future services offered at Ashurst House. Documents viewed during the inspection, including care plans, policies and procedures, shift guidelines, and supervision schedules, all evidenced that service users health, welfare and safety are promoted and protected. Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 21 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 3 X X 3 X Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Ashurst House DS0000057495.V318294.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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