Inspection on 03/08/05 for Ashwood

This inspection was carried out on 3rd August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashwood 28/06/07

Ashwood 13/06/06

Ashwood 11/01/06

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 Stephanie Omosevwerha Unannounced 3 August 2005 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. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 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 CRH PC - Care Home Only 3 Category(ies) of LD Learning disability (3) registration, with number of places Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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. Date of last inspection 21 March 2005 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. The home is located close to shops, bus routes and other local amenities. The home’s 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 and it benefits 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. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over approximately 4 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. The inspector initially met with Mrs Van Wyk (the registered provider’s wife) and examined various records and documentation including care plans, risk assessments and health and safety records. The inspector also conducted a tour of the premises viewing all communal areas of the home and all service users bedrooms. The inspector returned to the home later in the evening and met will all three service users after they had returned from their day-time activities and spent approximately 1 ½ hours talking to them. What the service does well: The home offers a small, family type environment in which service users are offered a great deal of choice and opportunities to promote their independence. There is a relaxed atmosphere with service users freely using the communal areas and making themselves drinks and snacks. Service users expressed a great deal of satisfaction about their care saying Ashwood was like “my second home”. They also felt they were “treated like adults”. The home has good links with the local community and service users benefit from a variety of different work, educational and social activities including at least one holiday abroad during the year. All the care is provided by the registered provider and his wife which means they have a great deal of knowledge and understanding about individual service users needs and are able to offer excellent consistency of care. There is evidence of good liaison with families who are welcome to visit and service users are encouraged to maintain regular contact. The home also works with other professionals to ensure service users physical and emotional needs are well met. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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) 2. An admission procedure is in place that ensures prospective service users are only admitted on the basis of a proper assessment and subsequent trial period ensuring the home is confident the service they provide will meet potential service users’ needs. EVIDENCE: There have been no new admissions to the home since January 2005. There was evidence on service users’ files that care management assessments and plans were in place. Service users confirmed they had been able to visit the home prior to their admission and that they were confident their needs would be met by the home. The registered provider told the inspector that relatives and other interested parties e.g. advocates had also been involved in the admission process. There was further evidence on service users’ files that all placements were subject to a 12 week trial period and a review was held after this with the service user, care manager and family if appropriate to make the place permanent if all parties were happy with the arrangements. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9. The registered providers have a detailed knowledge of all residents ensuring that their needs are well met and any changes to their care can quickly be incorporated into their plans. The small family type living environment offers service users a great deal of choice and flexibility allowing them freedom to make decisions about their lives. The home has appropriate policies and procedures in place for assessing and managing risks, which are based on enabling service users to take responsible risks rather than preventing them from doing so. EVIDENCE: All service users’ care plans were viewed. These provided comprehensive information about service users’ general health and mental health, finances, mobility, personal care, communication, family and friends, daily activities, eating and drinking and household tasks. Examples of likes and dislikes were recorded e.g. “likes to assist with preparation of meals” and “prefers a shower to a bath. Support needs were also clearly specified e.g. “verbal prompts are sufficient” and “requires supervision with cooking”. There was further Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 10 evidence that plans were reviewed regularly with any amendments being signed and dated. Discussion with service users 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”, “showering when you want” and “getting our own breakfasts and packed lunches and being able to make drinks”. Any limitations to service users on service users choices were clearly evidenced on service users care plans and agreed with other professionals where appropriate. All service users 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. The use of advocacy was encouraged and one service user had an advocate to assist him during the transition period of moving into the home. There was evidence that the home was managing risks well with strategies in place to promote service users independence rather than restrict them, e.g. risk assessments were in place to enable one service user to cycle to his work placement and other assessments ensured the safety of other activities such as cooking, bathing/showering and using cleaning materials. There was also a comprehensive fire risk assessment in place for the whole building ensuring the service users safety in the home. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. Service users have good links to their local community offering them the opportunity to take part in a range of work, educational, social and leisure pursuits. Family relationships are supported and maintained by regular visits and telephone contact. EVIDENCE: A record of each service users weekly activities was recorded. 2 service users had regular daytime activities including attendance at a day centre, horticultural work experience, recycling work experience and removal work experience. One service user currently had only one day of organised activities, however, he had successfully completed a 2-week assessment to undertake a 3-year college course starting in September. All service users said they were happy with the activities arranged for them. On the day of the inspection one service user had gone to his usual daytime activities and the other two service users had gone shopping in a local town centre and had travelled back on public transport. Service users told the inspector that they regularly used various amenities in the community Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 12 including banks, library, shops and clubs/pubs. All service users were able to access the local shops independently and the home had also enabled them to use public transport to the local town centre of Poole independently. Service users were also included in family outings with the proprietors and the home has a MPV available to allow everyone to go out together. The service users told the inspector they were particularly looking forward to their holiday in France in a couple of weeks time. Service users were able to keep in touch regularly with their families, one service user regularly stayed with relatives on weekend visits and the other two service users had regular visits from relatives who either visited them at the home or took them out for the day. 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. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 standard(s) 18 and 19. Personal support is offered in a way that promotes the service users’ privacy and independence. The physical and emotional health needs of service users are well met with multi disciplinary working taking place as appropriate. EVIDENCE: There was evidence that service users were receiving the personal support they needed. Support needs were clearly recorded on care plans, although all 3 service users were fairly independent and the majority of care needed was verbal prompts to ensure residents had washed, shaved and taken showers as appropriate. Service users said their privacy was respected and felt they were “treated like adults”. All service users were registered with a local G.P. Any health care needs were clearly recorded e.g. one service user needs to wear a mask to bed attached to a machine that distributes air through his nasal passages. Other health conditions were monitored such as epilepsy or mild compulsive/obsessive behaviours with support from other professionals where appropriate e.g. consultant psychiatrist. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 standard(s) 22. Systems were in place to enable service users to express their views, although residents did not always feel confident about raising issues with the registered provider. EVIDENCE: The home has a written complaints policy and procedure. Service users were aware of the procedure and were able to tell the inspector whom they could talk to apart from the registered provider, e.g. family, advocate, social worker and the inspector. Whilst service users said they felt confident in approaching Mrs Van Wyk they said they were not always sure about talking to Mr Van Wyk. Service users said they were generally happy with their care and felt like it “is my second home”, however, they wanted to make the inspector aware that Mr Van Wyk manner sometimes made them feel a “bit worried” specifically “sometimes when we have done something wrong”. The inspector agreed to speak to Mr Van Wyk about this separately to the inspection. It is recommended, however, that Mr Van Wyk carry out training concerned with assertiveness to develop a better awareness of defining behaviours and finding different solutions to manage these. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 standard(s) 24. The home maintains a good standard of décor and furnishings that provides service users with a comfortable, homely, family-type environment. EVIDENCE: A tour of the premises was carried out as part of the inspection and all communal spaces and service users bedrooms were viewed. Since the previous inspection the hall and stairs have been redecorated and a new suite had been purchased for the lounge. Service users bedrooms had been redecorated and a new carpet had been put in one service users room. There was also a new shower installed in the downstairs shower room. There had been further work carried out outside including a new front wall and the front garden being landscaped. Service users had participated in working in the back garden to clear space to make it more user friendly. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34. The home does not employ any staff and all care is provided by the registered providers. Complete records need to be held for any person that is employed on a relief basis to work in the home to ensure the safety of service users living in the home at all times. EVIDENCE: The home employs no staff as the registered provider and his wife provide all of the care. When it has been necessary for them to have a break, a regular relief worker provides cover in the home. There has been an outstanding requirement for further documentation to be held concerning the relief worker in the home to ensure the protection of service users in the home. Although evidence has been seen that a suitable CRB check and qualifications are place, there is still a need to provide references and photographic proof of identity. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 17 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 and 42. There has been some attempt to monitor quality in the home, however, more formal systems of recording would provide clearer evidence about plans to develop and improve the service based on the views of service users and other interested parties. Practices in the home promoted and safeguarded the health, safety and welfare of the people using the services. EVIDENCE: There was some evidence that the registered person had attempted to get the views of interested parties about the quality of the service by sending out questionnaires to relatives. It was recommended at a previous inspection that it might be useful to carry out a service user questionnaire. Further discussion with the registered provider at this inspection concluded that this was not conducive with the ethos of a small family type home and the views of service users were consistently sought on a more informal basis. It was recommended, therefore, that the registered provider develop a system of Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 18 recording service users views/ideas so these would not be ‘lost’. This information could then be used to form the basis of an annual development plan. Service users confirmed that the registered provider “listens to our views”. There was further evidence that policies and procedures were reviewed on a regular basis. Health and safety matters were generally well managed in the home. A fire risk assessment had been completed for the building and records showed that checks and drills were carried out on a regular basis. Service users confirmed they knew what to do in a fire drill and were able to describe the procedure to the inspector. The registered provider was aware of legislation regarded health and safety and policies and procedures reflected this. Both Mr and Mrs Van Wyk have undertaken courses in safe working topics including fire training, food hygiene, manual handling and the administration of medication. There was further evidence that facilities and equipment was being serviced at regular intervals. Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x x x 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 20 Yes 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 34 Regulation 19 Requirement The registered provider must not employ a person to work in the care home unless he has first obtained the information and documents specified in paragraphs 1 - 7 of Schedule 2 of the Care Homes Regulations 2001. Specifically photographic proof of ID and 2 references. This is the third time this requirement has been repeated. Timescale for action 1 October 2005 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 22 Good Practice Recommendations It is recommended that the registered provider carry out training concerned with assertiveness to develop a better awareness of defining behaviours and finding different solutions to manage these. It is recommended that the registered provider develop a system of recording service users views/ideas so these will not be ‘lost’. This information could then be used to form the basis of an annual development plan. 2. 39 Ashwood D55 S4011 Ashwood V243593 030805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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