Inspection on 11/05/05 for Ashview House

This inspection was carried out on 11th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashview House 12/12/07

Ashview House 25/01/07

Ashview House 27/06/06

Ashview House 16/01/06

Ashview House 29/10/04

Ashview House 20/05/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Ashview House Riverview, High Road Vange, Basildon Essex SS16 4TR Lead Inspector Claire Brookes - Nandara Unannounced 11 May 2005 10:00am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Ashview house Address Riverview, High Road Vange Basildon Essex SS16 4TR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01268 583083 01268 583675 Ashview House Limited CRH 13 Category(ies) of LD & PD registration, with number of places Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29/10/04 Brief Description of the Service: Ashview House is a care home providing personal care and accomodation for up to thirteen residents who have a learning disability, including up to three people with physical disabilities. The home is a two storey detached house situated in a cul-de-sac, in a residential area and is close to the local amenities. There is parking facilities available to the front and side of the building, and the home has a garden with a bird avery and chicken coop. Three mini buses are available to transport the residents to their activities and to college. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in May 2005. The Lead Inspector was accompanied by a second inspector (Ron Reeves) on the day. We took a tour of the premises and spent time talking to and observing the residents whilst they interacted with their peers and the staff of Ashview House. Four staff and the home’s manager were spoken to during the course of the day. What the service does well: What has improved since the last inspection? Two showers are now available in the home for wheelchair users. One is available on the ground floor, and another upstairs on the first floor. The bathrooms and toilets are equipped with hoists and mobility aids, to promote the residents’ independence. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 standard(s) 1,4 &5 The Service User Guide is written to a high standard, but it needs some modification in order to completely meet the requirement for what it should contain. Introductory visits for new residents are already carried out effectively. EVIDENCE: The Service User Guide does not contain all of the information required in the National Minimum Standards. However the current content of the booklet is useful for the residents, and is creatively presented with bright user-friendly cartoon illustrations. On the day of the inspection a prospective resident was viewing the home. Staff from Ashview have already paid him an introductory visit in his current accommodation, and he was there to meet the other residents to see if he liked the home. The inspector was told that this young man would have the opportunity to plan his own transition into the home. Including opportunities for further visits, over-night and weekend trial stays. Whilst touring Ashview House, he was asked what he thought of the home so far. He said: “It seems quite nice… the staff are nice” There has now been a Service User Contract put in place, but it has some short falls. It does not specify which room is to be occupied and there is no terms Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 9 and conditions of the occupancy. The rights and responsibilities of both parties are unclear, and there was no Service User Plan or arrangements for reviews included. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 standard(s) 8 & 9 The residents are not adequately consulted with, regarding issues surrounding the home. The homes current Missing Persons form needs to advise staff of when to inform relatives, CSCI and other necessary professionals. EVIDENCE: There have not been any regular residents meetings held for a very long time. The inspectors noted that several residents had some very strong opinions about their lives at Ashview House, and the things that they would like to change. The décor of the premises was frequently mentioned, and the inspector was asked to make several requests to the manager on their behalf for changes within the home. All residents spoken to say that they would like regular residents meetings with the manager, so that they can have a chance to express their views. Wherever possible the residents are actively encouraged to lead independent lives. Any recognised risks or hazards should be identified within individual risk assessments to avoid limiting a residents’ preferred activity or choice. The home does have a written Missing Persons Procedure to follow in case of Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 11 unexplained absences. However it does not advise of a time where by the residents’ relatives and the CSCI need to be informed. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 standard(s) 11, 12, 13 & 17 More residents could be encouraged to attend some form of college course or employment to occupy them and further develop their life skills. Opportunities for the residents to attend activities were not available often enough. The residents are provided with a good choice of nutritious meals and snacks. EVIDENCE: The residents’ personal development is encouraged. Two individuals currently attend college on a regular basis. There is usually age and peer appropriate, community based leisure activities on offer at the home. These include evenings out to play snooker and darts, day trips, and social clubs. Residents spoken to said that they very much enjoy their activities, but recently the opportunity to attend them has become much less frequent. One resident mentioned that he had enjoyed visiting a friend of his who lives locally in another residential home. But he was disappointed that he hasn’t yet had the opportunity to invite him back to his home in return. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 13 The Kitchen in the home is very well stocked with food. There are a wide variety of drinks and snacks available to the residents, and there were plenty of nutritious foods in the fridge and freezer available to make hot meals. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 standard(s) 20 The medication files that have “Side Effects” sheets included in them are excellent. In general the medication records were in good order, but the lack of continuity within the files could lead to confusion for the staff that administer the drugs. Only senior staff who have received training, are permitted to administer medications. EVIDENCE: Each resident has a Medication Administration Record kept in a folder. There is a “Side Effects” sheet, listing all possible symptoms of the various medications available, for eight of the residents. There had been some confusion at the pharmacy when the sheets were printed, so some people had a written duplicate in their file. One resident had a medication record, but no longer needed one and there were several omissions in the apparent administration of the medicines. Only the senior staff are trained to give out medication. They have all signed to say that they have had the necessary training and that they understand all of the related policies and procedures. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The complaints procedure does not contain all the elements required. EVIDENCE: Ashview House has a Complaints Procedure document available. It describes to the complainant the process that will occur, and the stages that need to be followed. But despite there being space on the form for the information to be hand written, it does not include how to contact the CSCI. In fact it wrongly advises people to contact the NCSC – with no address supplied. The Abuse Policy refers people to the Complaints Procedure as part of adult protection, which compounds the problem referred to above. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 & 30 The home is not decorated in a homely or attractive style. The bathing and toileting facilities have adequate equipment supplied to support the residents’ independence. The residents’ bedrooms are pleasant and have been personalised by the people who occupy them. The bedrooms promote the residents independence, as they are encouraged to take care of the rooms themselves. EVIDENCE: The downstairs lounge is dark and gloomy, with badly worn furniture. The flooring throughout the lounge and conservatory / dinning area is heavily soiled and stained. The layout of the furniture allows wheel chair users to manoeuvre their way around, but it does not make best use of the space available. The upstairs hallways look institutional and one part has no lighting due to broken bulbs. Two residents showed this to the inspector, and said that they didn’t like the way the corridors looked. One said: “I don’t like it, it needs to be brighter. Or we could have some pictures up or something… it could be painted yellow” Another resident said: “Before the lights went, they were flashing for ages – even the staff said!” Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 17 The service users bedrooms were pleasant and well decorated, and the residents have been able to personalise their rooms with their own possessions and favourite things. The residents are encouraged to live as independently as possible, and they are encouraged to clean and look after their own rooms. On the ground floor the bathrooms have frames and equipment such as hoists to aid the residents when using the facilities, and there are now two shower rooms designed especially for disabled people. The home is generally clean and hygienic, and gloves and aprons are readily available in the toilets and bathrooms for staff to use when assisting the residents. Bags are available in the laundry room, for use with any soiled linen, but they were on the floor behind laundry baskets and therefore not very accessible. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 36 The home does not always have an acceptable number of staff on shift, to fully support the residents and their individual needs. Staff recruited to work in the home are invited to attend team meetings, and are offered regular supervision. EVIDENCE: The staff duty rota was inspected. And it was found that on several occasions there has not been a sufficient number of staff on shift to care for the residents and their needs. There should be at least five staff working on a day shift, but some days as few as three staff have been recorded on the rota. The homes’ acting manager holds regular individual supervision with the staff, and aims to facilitate team meetings every four to six weeks. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 There are no Quality Assurance systems applied in Ashview House for the residents to share their views. There was not sufficient evidence to show that some safety procedures had been dealt with properly. EVIDENCE: The residents do not currently have a forum available to them, where by they can express their views. There are no residents meetings held, and no questionnaires or surveys provided for them or their relatives / representatives to offer feedback about the service that they are receiving. Certificates for the safety of the electrical equipment in the home were not available, neither were the gas maintenance certificates. Fire drills are carried out, but not properly recorded. There is no risk assessment in place for Legionella in the water. Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x 3 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 1 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 2 x 3 Standard No 11 12 13 14 15 Ashview House 3 3 2 x x Standard No 31 32 33 34 35 36 Score x x 2 x x 3 Version 1.20 Page 21 I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 22 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 4 Sch 1 Requirement The registered person must revise the current Statement of Purpose to include all of the required information detailed in schedule one of The Care Homes Regulations. The registered person must ensure that all residents are provided with an adequate contract of the terms and conditions of their occupancy. The registered person needs to include guidance along with the homes Missing Persons form as to when relatives and the CSCI needs to be informed of an incident. The registered person must make sure that the medication records are well organised and consistently maintained. The registered person must also ensure that the dispensing pharmacy prints the correct data on each Medication Administration Record at the time of collection. The registered person must include the correct name, address and telephone number in the Complaints Procedure, and Timescale for action 1/12/05 2. YA5 5(1)(b) (c) 1/12/05 3. YA9 12 (1) 1/12/05 4. YA20 17(1)(a) 8/8/05 5. YA22 YA23 22(7)(a) 13(6) 1/12/05 Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 23 in the Abuse Policy. 6. YA24 23(b)(d) The registered person must provide the residents with a properly maintained, well decorated and homely environment. The registered person must provide comfortable and fully accessible communal areas in the home, that complement and supplement the residents individual rooms. The registered person must ensure that the residents have the opportunity, to regularly express their views and share suggestions about their lives and the home. The registered person must make sure that there is the correct number of staff working on each shift at all times, in order to meet the residents needs. There should be at least five staff on shift during the day. The registered person must see that evidence is always available to prove that checks have been carried out for electrical installations, gas appliances, fire safety equipment, portable appliances and testing for legionella. 1/12/05 7. YA28 23(i) 1/12/05 8. YA8 YA39 24(1)(a) (b)(3) 1/9/05 9. YA3 YA33 18(1)(a) 8/8/05 10. YA42 13(4)(a) (b)(c) 1/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashview House I56 I06 S18107 Ashview House V222421 110505 Stage 4.doc Version 1.20 Page 25 - 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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