Inspection on 16/01/06 for Ashview House

This inspection was carried out on 16th January 2006.

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 11 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 11/05/05

Ashview House 29/10/04

Ashview House 20/05/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

Grangewood

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 Michelle Love Unannounced Inspection 16th January 2006 10:20 Ashview House DS0000018107.V279387.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 Ashview House DS0000018107.V279387.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. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashview House Address 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) Riverview High Road Vange Basildon Essex SS16 4TR 01268 583043 01268 583675 Ashview House Limited Manager post vacant Care Home 13 Category(ies) of Learning disability (13), Physical disability (3) registration, with number of places Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: Ashview House is a care home providing personal care and accommodation 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 local amenities. There is parking facilities available to the front and side of the building, and the home has a garden. The home has its own transport to enable residents to access the community. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by Michelle Love and lasted approximately 8 hours. On the day of inspection all residents were observed to be at the care home, however during the day several were seen to access a variety of community activities/adult education classes. A tour of the premises was undertaken and a number of records pertaining to care plans/risk assessments/healthcare records, staff employment files, staff training files, medication records and safety certificates were examined. The inspection was conducted with the assistance of one senior member of staff and the registered provider’s Operations Manager. During the inspection no visitors were observed at the care home, however several residents were spoken with. As a result of concerns pertaining to physical, psychological and financial abuse of residents, the home is being monitored and investigated under Protection of Vulnerable Adults procedures. Agencies other than the Commission for Social Care Inspection involved include Essex Police, Essex Social Services and other Placing Authorities. The previous manager and one member of support staff has since left the employment of Ashview House/Beacon Care as a result of investigations carried out. The home is currently being managed by Gary Scott Operations Manager, and a newly appointed acting manager. Beacon Care have advised that the post of manager is to be advertised. What the service does well: What has improved since the last inspection? Since the last inspection the previous manager has been disciplined and left the employment of Beacon Care, following allegations of financial, physical and psychological abuse of residents within the home. Following discussions with both support staff and residents, all have commented that his departure has Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 6 been positive and that the atmosphere within the home is much better and lighter. Some areas of the home have been redecorated and are much brighter in appearance. Resident’s bedrooms remain personalised and individualised. 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. Ashview House DS0000018107.V279387.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 Ashview House DS0000018107.V279387.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): 2, 3 and 4 Prospective residents are assessed prior to admission, and have the opportunity to visit the care home to determine whether or not this is the right home for them. Training records evidence that not all members of staff have attained/undertaken appropriate training to meet residents needs. EVIDENCE: Since the last inspection one new resident has been admitted to the care home. A detailed pre admission assessment was completed enabling the registered provider to make an `informed` choice as to whether or not it was able to meet the individuals complex needs. On inspection of staff training records it was evident that some members of staff have not received mandatory/specialist training, which meets individual residents needs i.e. eight out of thirteen residents are currently wheelchair users and suffer with a range of physical disabilities. Of those records inspected no members of staff were observed to have training relating to such conditions as cerebral palsy/physical disabilities/visual impairment. In addition some gaps were observed whereby not all mandatory training has been undertaken/attained or updated. The newly appointed Operations Manager has devised a staff training profile to determine training already undertaken and to decipher gaps. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 A plan of care is available for all residents and includes risk assessments, however some folders were muddled. Following management changes to the home, effort is being made by support staff to enable residents to make decisions about their lives. EVIDENCE: On inspection of four individual care plans, these were in general seen to be relatively detailed and informative with information relating to residents social, physical, healthcare and emotional care needs. Some care plans require additional information e.g. one care plan made reference to the resident having limited communication. No specific information was recorded identifying his specific communication difficulties and how support staff, communicate with him. Care records were somewhat muddled however the inspector was advised by one senior support worker and the Operations Manager that a new care plan format is being introduced. Pen portraits for individual residents were completed. Daily care records for residents were on most occasions written daily, but in some instances these were not and contained limited information evidencing how residents spent their day and activities undertaken. Daily care records did not always detail the specific nature of residents physical aggression/inappropriate behaviours or support staff’s interventions i.e. one Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 10 care plan made reference to a resident exhibiting very aggressive behaviours and demanding a cup of tea. Records did not detail the nature of the aggression i.e. physical or verbal and did not include evidence of how support staff dealt with the situation. It was positive to note that of those care plans inspected, behaviour management guidelines were in place. The registered person must ensure that behaviour management guidelines are reviewed as one resident’s guidelines were last reviewed in June 2002. It is unclear as to whether or not these guidelines remain relevant. Risk assessments were available for some areas of assessed risk but not in some cases. Additionally some risk assessments had not been reviewed since September 2004. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 and 16 A limited programme of meaningful activities and stimulation is available for residents. Family and friends are welcome to visit the care home. Little evidence is available to indicate that residents participate within the day-today running of the home. EVIDENCE: On the day of inspection, a number of residents were taken out by support staff (out for lunch and for some members to attend basketball). Resident’s comments were positive regarding their enjoyment of both activities. However on inspection of residents daily care notes there was limited evidence to indicate that they receive a regular varied programme of activities, which meet their individual needs. The home operates an `open` visiting policy whereby relatives and friends of residents can visit the care home at any reasonable time. Records indicate that many residents residing at Ashview House have regular access to family/friends. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 12 There is limited evidence to indicate that residents are actively encouraged and empowered to participate within the day-to day running and routines of the home. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents are supported to have their healthcare needs met. The home’s medication administration, policies and procedures are appropriate and satisfactory. EVIDENCE: From inspection of residents care files and daily care records, records indicate that residents have access to a range of healthcare professionals and facilities i.e. GP, Consultant Psychiatry, Local Hospitals, Dentist, Behaviour Therapy Services etc. Specialist equipment is available for residents i.e. wheelchairs, grab rails and hoists. Medication Administration Records were inspected and satisfactory. No changes have been made to the home’s medication policies and procedures since the last inspection. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 A complaints procedure is available within the home, however it is evident that the previous manager of Ashview House had little regard of its content and did little to listen to residents, support staff or residents relatives. Following the last inspection, residents were not protected from physical, psychological and financial abuse. EVIDENCE: The complaints procedure has been amended and now correctly describes to the complainant the home’s processes and who to contact. Residents have not been safeguarded from physical, psychological and financial abuse. Despite an investigation by the registered provider and the resignation of the previous manager, issues are being further investigated by the police, social services, other placing authorities and the Commission for Social Care Inspection. The previous manager has been referred for inclusion on the temporary POVA list. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The home has undergone redecoration since the last inspection and now provides residents with a comfortable and safe environment. EVIDENCE: Since the last inspection the home has been redecorated. The home is much brighter and on the day of inspection was clean, tidy and odour free. Individual residents bedrooms were seen to be personalised and contained residents personal effects. Flooring within the home has been replaced since the last inspection. As stated at the last inspection one part of the hallway (first floor) has dull/no lighting due to bulbs not working/fuses blowing. One resident’s bedroom was observed to have a `baby gate` fitted. The senior in charge of the shift was advised that this is inappropriate and is seen as a form of restraint. From discussions with the senior in charge, the resident receives 1-1 staff support and therefore the above restrictive piece of equipment is inappropriate. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35 and 36 Staffing levels within the home were satisfactory for the needs and numbers of existing residents. Not all records as required by regulation pertaining to staff recruitment had been sought. Support staff had not received supervision on a regular basis. EVIDENCE: On inspection of staff rosters from 19.12.2005 to 16.1.2006, staffing levels were seen to be appropriate and included additional 1-1 staffing arrangements for two residents. Staff rosters evidence that some staff are consistently working long days/excessive hours i.e. week commencing 19.12.2005, one member of staff worked three long days and two 7.5 hour shifts totalling 61.5 hours. Other staff members were seen to work a total of up to 62.5, 64.5, 70, 72 and 82.5 hours in any one week. The newly appointed Operations Director was advised that this is not good practice and places both residents and support staff at risk. Staff rosters do not include the full names of agency staff utilised at the care home and do not identify those members of staff providing 1-1 support for residents. The Commission for Social Care Inspection was concerned to find out that a member of staff implicated on recent protection of vulnerable adults issues had remained working at the home. Following the inspection, the Commission was notified that due to other issues their employment was terminated. It is unclear as to whether or not they have been referred to the temporary POVA list. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 17 Since the last inspection four new members of staff have been appointed. Not all records as required by regulation had been sought and some gaps were observed pertaining to no photograph, no proof of identification, no proof of training/qualifications, no contract, no record of induction, only one reference available for two members of staff, employment history not fully explored for one member of staff and not all had a health status declaration. For one member of staff it was unclear as to their visa/immigration status. A staff training profile has been newly implemented by the Operations Manager to identify current training and future training requirements. Records detail that some support staff have received mandatory training, however there are some gaps i.e. Fire Awareness, Infection Control, Health and Safety and Basic First Aid. Some mandatory training for support staff was observed to be out of date and needs reviewing. Limited evidence was available to indicate that support staff have received specialist training to meet the specific needs of residents. Supervision records were not available for all members of staff. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 and 42 The home is without a permanent manager at this time, however it is hoped that a more settled period will now ensue at Ashview House. The health and safety of residents are safeguarded and promoted at the home in relation to some of its records. EVIDENCE: At the time of the inspection the home was without a permanent manager. The home is currently being overseen by Beacon Care’s Operations Manager and the manager of Ashview House’s sister home. A `caretaker` manager is planned until the post is advertised and on paper appears to have the qualifications and experience to run the home. A number of records relating to the homes passenger lift, gas and electrical safety installation certificates, hoist service reports, employers liability certificate and fire drill/extinguisher reports were seen and all were deemed satisfactory. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 19 Resident’s monies and records were inspected and seen to be satisfactory with monetary totals and receipts clearly evident and correct. Currently Beacon Care are in the process of undertaking a financial audit/investigation pertaining to alleged allegations of financial abuse/misappropriation of resident’s funds. Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 2 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 X 33 2 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 2 14 X 15 3 16 2 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X X X 3 X Ashview House DS0000018107.V279387.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 4 Standard YA35YA3 YA6 YA9 YA13 Regulation Requirement Timescale for action 01/07/06 01/05/06 01/04/06 01/04/06 5 6 YA23 YA24 7 8 9 YA33 YA33 YA34 18(1)(c)(i) Ensure that all staff receive appropriate mandatory and specialist training. 15(1) Ensure that care plans are detailed and comprehensive for all residents. 13(4)(c) Ensure that all risks are identified and recorded within the care plan for residents. 16(2)(m) Ensure that all residents (n) participate within a meaningful and stimulating programme of activities. 13(6) Ensure that residents are safeguarded against abuse and not placed at risk. 13(7) Ensure that no resident is subject to restraint. This refers to the removal of the `baby gate` in one resident’s bedroom. 18(1)(a) Ensure that sufficient numbers of staff are on duty and that they do not work too many hours. 17(2), Sch Ensure that the duty roster 4 (7) identifies all staff working in the care home. 19, Sch 2 Ensure that all records as required by regulation are sought and available for inspection. DS0000018107.V279387.R01.S.doc 11/02/06 11/02/06 01/03/06 11/02/06 01/03/06 Ashview House Version 5.1 Page 22 10 YA36 18(2) Ensure that all staff are supervised. 01/03/06 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 2 Refer to Standard YA16 YA35 Good Practice Recommendations Ensure that residents are encouraged to participate within the day-to-day running of the home. All newly appointed staff receive an induction. 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