Inspection on 28/06/07 for Ashwood

This inspection was carried out on 28th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Ashwood 13/06/06

Ashwood 11/01/06

Ashwood 03/08/05

Ashwood 21/03/05

Ashwood 10/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Ashwood 12 Dudley Road Northbourne Bournemouth Dorset BH10 6BS Lead Inspector Tracey Cockburn Key Unannounced Inspection 28th June 2007 10:00 Ashwood DS0000004011.V343447.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 Ashwood DS0000004011.V343447.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. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Address 12 Dudley Road Northbourne Bournemouth Dorset BH10 6BS 01202 770242 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) Mr Jonathan Ashwood Van-Wyk Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service user to be accommodated in the second floor room must not be dependent on staff for means of their escape in the event of a fire. 13th June 2006 Date of last inspection Brief Description of the Service: Ashwood is a semi-detached family house situated in Northbourne, a suburb of Bournemouth. It is registered to provide personal care for three adults with learning disabilities and there were no vacancies at the time of the inspection. Details of current fee levels have been made available to CSCI; however, the provider does not wish these to be published. Fee levels would be discussed with individuals on application to the home. The home is located close to shops, bus routes and other local amenities. The homes statement of purpose includes the following aim; to support young adults to learn new skills and maintain and increase their independence. In pursuing this aim the registered person assists and supports service users to attend or undertake further education and employment opportunities as well as access the local community and its amenities. The building has no features that distinguish it from other similar properties in the street. The premises are spacious benefiting from a loft conversion and there is accommodation on three floors. The three service users have single bedrooms on the first and second floor. A bathroom and WC are easily accessible. Communal space is shared with the registered providers and this includes a lounge, kitchen/diner, conservatory, ground floor shower room and WC, utility area and gardens to the front and rear of the property. The registered providers work full time in the home and one has previous experience of working for a local authority in services for adults with learning disabilities. The domestic nature and character of the home enables service users to benefit from living in a family environment. The current weekly fees are £525. Further information on fees and contracts can be found on the Office of Fair Trading website: www.oft.gov.uk Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place without any warning and lasted 2.5 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI and to address the requirements and recommendations made at the previous inspection. This inspection was a key inspection and therefore, assessed all identified key standards for care homes for adults. Additional information received by the inspector prior to the inspection was also taken into account. This included the Annual Quality Assurance Assessment completed by the registered person, 1 service user survey and other information such as Regulation 37 notifications of significant events in the home. At the time of the inspection there were only 2 people living in the service. What the service does well: This service ensures that people who are considering whether or not they might want to live there have an assessment of their needs before any decisions are made so they know whether or not the home can meet their needs. People who live in this service say they have a care plan which identifies their needs and goals and how to achieve them. They also say they are able to make decisions about their lives. Risk assessments are regularly reviewed and changed according to changes in circumstances. People who live in the service are able to participate in activities, which interest them and they are part of the local community. Resident’s are able to have relationships with the people they want to and live the life they want. People who live in this service are encouraged to eat healthily and be responsible for preparing the food they eat. People who live in the service are supported in the way they prefer and are supported to meet their physical and emotional needs. People are encouraged to take responsibility for their actions and for keeping themselves healthy by taking their medication. People who live in the service are encouraged to express their point of view. 1 person said they felt they could “talk to the providers if they were worried” 1 person said they would always contact their social worker for they had a concern. People live in a home they like which they say is homely. It is clean. The registered provider ensures he is up to date with training so he can meet the needs of the people who live in the service. The provider also ensures that the views of the people who live in the service are part of its development. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Ashwood DS0000004011.V343447.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 Ashwood DS0000004011.V343447.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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. An admission procedure ensures people who are considering moving into the service have an assessment and trial period this means the provider can be confident the service will meet potential service users’ needs. EVIDENCE: There have been no new admissions to the home since January 2005. The home has an admission policy and previous inspections have provided evidence on the service users’ files that care management assessments and plans were in place for all service users admitted to the home. Information is available to prospective new residents and there is a service user guide produced in an accessible format using clip art and simple text. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the service have their needs and goals in individual plans of care. People are able to make decisions about their lives with support and assistance and supported to take risks. EVIDENCE: 1 persons care plan was looked at. It provided comprehensive information about the person’s general health and mental health, finances, mobility, personal care, communication, family and friends, daily activities, eating and drinking and household tasks. There was good detailed information on how to support this person if they had a problem with a specific medical condition. There was also good written information on the signs to look for which would indicate this person was not happy. There was further evidence that plans were reviewed regularly with any amendments being signed and dated. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 10 Discussion with 1 person who lives in the service confirmed they felt their support needs were being met. They were able to make decisions about their lives and gave examples such as “going to bed when you want”. Any limitations to someone’s lifestyle are clearly evidenced on the care plan and agreed with other professionals where appropriate such as placing boundaries on certain types of behaviours. The registered provider gave a recent example for such a restriction and why it was necessary. Both the people who live in the service have their own banks accounts and are supported where necessary to manage their finances including support to use cash point machines and budgeting during the week. There was evidence that the home was managing risks well with strategies in place to promote service users independence rather than restrict them. This included risk assessments to enable access to different community activities. Other assessments ensured the safety of other activities such as cooking, bathing/showering and using cleaning materials. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who live in this service are able to take part in activities, which interest them in the local community. They are able to lead the life they want and have the relationships they want. People have their rights respected and are encouraged to take responsibility for their lives. A healthy diet is encouraged. EVIDENCE: A record of service users daily activities was kept on each individual’s file. All service users had regular organised daytime activities including day centre attendance, college attendance and work experience. Discussion with 1 person indicated they were happy with their weekly programme of activities. They also told the inspector they regularly accessed the community and gave examples such as catching the bus to a club, going out for meals and going to the local shops. Residents had all gone on holiday to the Dominican Republic Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 12 earlier in the year. The home has an allotment and 1 person who lives in the service said they really enjoyed working there with the registered provider Relative’s details were recorded on service users’ files. Service users were able to keep in touch regularly with their families. There was a payphone in the hall to assist service users to make calls to family and friends and service users also had their own personal mobile phones. 1 person who lives in the home said that he felt very supported. Discussion with the registered person indicated routines in the home were flexible accommodating individual’s needs. For example service users helped themselves to their own breakfasts and evening meals were generally eaten together but times could be adjusted to enable service users to attend evening activities. 1 person said they were able to be flexible in their daily routines they also said they felt their rights were respected, e.g. they could spend time in the privacy of their room, bath and shower when they choose and go to bed when they wanted. The proprietor said service users were responsible for keeping their own bedrooms clean and also participated in household tasks such as washing and drying up, hovering and cleaning bathrooms. Discussion with 1 service user confirmed they took part in all these tasks. A sample of menus was viewed as part of the inspection. This showed service users were offered a varied and nutritious diet and supported to follow a healthy eating plan. Service users usually helped themselves to their own breakfasts and made their own packed lunches. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service receive support in the way they prefer and their physical and emotional needs are met. The homes policy and procedure on medication ensures that individual’s are protected. EVIDENCE: There was evidence that service users were receiving the personal support they needed. Support needs were clearly recorded on care plans, although both people who live in the service are fairly independent and the majority of care needed was verbal prompts to ensure residents had washed, shaved and taken showers as appropriate. All service users were registered with a local G.P. Any health care needs were clearly recorded. Records of all appointments were kept such as visits to the G.P., dentist or optician. Other health conditions were monitored and appropriate health advice sought when necessary. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 14 Only one of the residents is currently taking medication. This service user is currently self-medicating. The home has satisfactory policies and procedures for administering medication. A record was kept of any homely medication taken. Ashwood DS0000004011.V343447.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): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the service feel their concerns are listened to and acted upon. There are systems in place to ensure proper procedures are followed to safeguard the people who live in the service. EVIDENCE: The home has a written complaints policy and procedure. 1 person who lives in the service told the inspector they could talk to the registered person and he would listen to them and take necessary action such as “ringing up the social worker”. This person also said they could talk to the registered persons wife. The home has policies and procedures in place concerning the protection of vulnerable adults. These included challenging behaviour, physical intervention and management of residents’ monies. A copy of the Department of Health guidance “No Secrets” was available in the home. Since the last inspection there has been an allegation of abuse. This was fully investigated and no evidence was found to support the allegation. The process caused considerable stress and anxiety to the registered provider who did not feel supported by the regulator. Even although the allegation was not upheld it was felt in the best interests of the resident concerned that they moved on to another placement. Ashwood DS0000004011.V343447.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): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a comfortable and homely environment, which is clean and hygienic. EVIDENCE: A tour of the premises was carried out as part of the inspection. All communal rooms were seen including the lounge, dining area, kitchen and laundry room. Bedrooms were not seen as neither person who lives there was present so their permission could not be sought. The premises were well maintained and decorated in a comfortable, homely way. 1 person spoke positively about their bedroom and their living environment. On the day of the inspection the home was observed to be clean, tidy and hygienic. The registered person is aware of procedures to control the spread of infection and an appropriate policy was seen during the inspection. The Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 17 laundry room is sited away from the kitchen. Separate hand washing facilities are provided and gloves are available. Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered person and his wife provide all care in the home. They are competent and qualified to meet the individual and joint needs of the people who live there. EVIDENCE: The home does not currently employ any staff but is owned and managed by the registered person and his wife who provide 24 hour care to the residents. When it has been necessary for them to have a break, a regular relief worker provides cover in the home. The registered person has obtained all the information and documents specified in paragraphs 1 – 7 of Schedule 2 of the Care Homes Regulations 2001 in respect of this person and these were shown to the inspector. Ashwood DS0000004011.V343447.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): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service benefit from a well run home, where their views are listened to and used to develop the service. Systems are in place in the home to ensure that the people who live there have their health, safety and welfare promoted and protected, EVIDENCE: Both the registered provider and his wife have previous experience of working with people with learning disabilities and prior to running a registered care home; they had been registered as adult placement carers. They regularly attend training courses and gain support through a provider reference group Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 20 and learning hub. They are also aware of Partners in Care and keep up to date with a variety of appropriate training courses. The home has developed a system to monitor the quality of the service. This is based on the views of residents, which are sought on a regular 6 weekly basis at house meetings. These are recorded so residents’ views can be incorporated in to the annual development plan. The registered person has produced a plan for 2006 – 2007 and this includes improvements to be made to the environment, service user plans such as cinema trips, working on an allotment and planning an annual holiday. The plan also included care plan goals such as help with budgeting to save money for outings service users have chosen to go on throughout the year. In the homes Annual Quality Assurance Assessment they make very clear their philosophy of running the home in a transparent way involving residents fully in decision-making. Records showed that fire checks and drills were carried out on a regular basis. 1 person living in the home said they knew what to do in a fire drill. The registered person was aware of legislation regarded health and safety and policies and procedures reflected this. Ashwood DS0000004011.V343447.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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Ashwood DS0000004011.V343447.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 Ashwood DS0000004011.V343447.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Ashwood DS0000004011.V343447.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!