Inspection on 11/01/07 for Ashwood Cheshire Home - Leonard Cheshire Disability

This inspection was carried out on 11th January 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 Cheshire Home - Leonard... 18/11/05

Ashwood Cheshire Home - Leonard... 08/06/05

Ashwood Cheshire Home - Leonard... 04/11/04

Ashwood Cheshire Home - Leonard... 22/06/04

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

CARE HOME ADULTS 18-65 Ashwood Cheshire Home 141 Chesswood Road Worthing West Sussex BN11 2AE Lead Inspector Mrs V Gay Unannounced Inspection 11th January 2007 12:30 Ashwood Cheshire Home DS0000014378.V325750.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 Cheshire Home DS0000014378.V325750.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 Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Cheshire Home Address 141 Chesswood Road Worthing West Sussex BN11 2AE 01903 230930 01903 239878 gill.donovan@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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) Mrs Gillian Donovan Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (3) of places Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 8 service users may be accommodated at any time of whom three persons over the age of sixty five years may be in the category LD(E). Only service users aged between 18 and 65 may be admitted. A maximum of eight service users in the category Learning Disability may be accommodated. 18th November 2005 Date of last inspection Brief Description of the Service: Ashwood Cheshire Home is a care home registered to accommodate up to eight residents in the category Learning Disability (LD), to include three persons over the age of 65 years, Learning Disability (LD) Elderly (E). The property is a large detached house located in a busy residential road in East Worthing. The home is within easy access of Worthing town centre and seafront. The building is an attractive double fronted two-storey house that stands in a street of similar properties. Bedrooms are located on both ground and first floor level. The Leonard Cheshire Foundation privately owns the service. The Responsible Individual on behalf of the organisation is Mr Peter Bray. Mrs Gill Donovan is the registered manager in charge of the day-to-day running of the home. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection, which took place on 11 January 2007 between 12-30 pm and 4-45pm. Prior to the inspection, the previous inspection report and pre-inspection questionnaire was reviewed, along with any correspondence received since the last inspection. There were no requirements or issues outstanding from the previous inspection. Comment cards were sent to the home to enable residents and relatives to comment on services provided. At the time of writing this report the inspector had received five completed questionnaires, one from a resident and four from relatives. The resident who responded was the only one able to complete the form and she was positive about the service in every respect. Three relatives comments included the following: “We are more than pleased with the service we and our daughter receive”. “No way could I ever wish for a better home for my daughter, she prefers being there than in my own place she is happy”. One relative made some adverse comments and it was evident that the registered manager was aware and would look at ways to resolve this matter. During the course of the inspection the inspector toured the home and reviewed records. The majority of residents were seen at the inspection however due to the diverseness of their disabilities it was difficult to chat to all residents in order to gain their opinions of the home. The inspector however took the opportunity to observe residents in their free time including their interaction with staff. Residents and staff appeared relaxed and confident in each other’s company. The range of weekly charges is £650.00 to £714.23. This does not include personal requisites. What the service does well: Eight residents living at at Ashwood Cheshire are provided with comfortable living accommodation, and a good standard of living. Staff support the residents with person centred planning to maximise their potential to improve their quality of life. There is a wide range of activities and friendships are encouraged in and out of the home. Some of the comments from residents during the inspection included the following: Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 6 “I like it here I am now retired I stay at home or I can go to college”. “I enjoy buying ingredients to cook with”. The atmosphere on arrival at the home was welcoming and relaxed. A member of staff with two residents had just returned from an outing to a garden centre. 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 Cheshire Home DS0000014378.V325750.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 Cheshire Home DS0000014378.V325750.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. The organisation has comprehensive policies and procedures in place in respect of assessment and admission procedures. For new residents assessments have been undertaken prior to admission and there has been good evidence of this. An assessment is also undertaken on admission. EVIDENCE: No residents have been admitted since the previous inspection in November 2005, therefore the inspector case tracked four files chosen at random. Records showed that full assessments are undertaken which are reviewed annually or as needs dictate. Residents are involved in this process using appropriate communication methods and with advocate as appropriate. The home has an admissions policy that would be followed if a new resident were to be admitted. Ashwood Cheshire Home DS0000014378.V325750.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. Individual care plans provide good and clear information about each resident. Members of staff help and support residents to make choices and decisions about all aspects of their lives. Residents are supported to be involved and have a say in aspects of life in the home. Choices made by residents and activities undertaken by them are supported in a way that considers and lessens any potential risk. EVIDENCE: All residents were spoken with during the course of the inspection. It was not possible to engage in meaningful conversation with the majority due to their varying communication needs. It was apparent however through observation how relaxed they were and that they had a good relationship with the staff. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 10 One resident said she enjoyed going to college “where I buy ingredients to make cakes”. Another resident showed the inspector her craft picture she had completed at the day centre she had attended that day. The care plans examined were very comprehensive and up to date. The staff complete a daily record sheet for each resident. Any changes in health and well-being is recorded in the communication book, and the care plan reviewed and the necessary action taken. Staff observed encouraged residents to make a decision, whether it be for choosing a colour for the pattern board they were making or for what individual task they were involved in. Risk assessments are in place for residents to enable them to maximise their potential and lead a fulfilling lifestyle. Residents make use of all local health related services and tap in to community resources. The home has policies regarding confidentiality. Staff have access to a copy in their staff handbook. The Service User Guide informs residents and their relatives that information given in confidence will not be disclosed. Ashwood Cheshire Home DS0000014378.V325750.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 good. This judgement has been made using available evidence including a visit to this service. Activities for residents are well managed, creative and provide a variety of stimulation and interest for residents living in the home. Residents are supported to maintain contact with family and friends. Residents are supported to follow a healthy diet and have a choice about the food they eat. EVIDENCE: Records examined, residents and staff interviewed during the inspection indicated that good practices were being followed in the home. Residents attend college, day-care centres and accompany the staff on shopping trips during the week. Two residents due to their age and specific needs are now retired and chose to remain in the home and not attend day facilities unless they particularly request to do so. A resident said she liked to stay at home now she was retired, and that she enjoyed watching the television, knitting scarves and helping the staff with some light domestic tasks. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 12 Friendships are encouraged and residents enjoy a good social life. The home has a vehicle to use to transport residents to their daily venues. The daily routines although necessarily fairly focused on routines are flexible to meet the needs of each resident. One resident likes to spend a considerable amount of time eating his lunch and the staff on duty respected this. Handovers and staff meetings discuss the resident’s well-being and any reported concerns are acted upon. Staff respected the privacy of residents by knocking on their bedroom doors and asking permission before showing the inspector their rooms. Residents were neatly dressed and tidy in appearance. Residents told the inspector that they enjoyed their food, which appeared fresh and appetising. Each resident takes a packed lunch to the day care centre, and the main meal is provided in the evening. A rotating menu is used and staff members shop twice a week to purchase fresh produce. Residents can make drinks by themselves or with the help of the staff whenever they choose. The lunchtime meal taken by two residents, a member of staff, and the registered manager was a relaxed occasion. One resident told the inspector she had enjoyed her toasted sandwich, another resident who was not able to communicate enjoyed a plate of spaghetti bolognese and toast. The main meal of the day was vegetable casserole and quorn followed by orange sponge pudding with custard. Residents seemed to be pleased with the choice of meal. The nutrional needs of residents are recorded and residents are weighed regularly to monitor their health. Staff on duty attend to the preparation and cooking duties assisted by residents if at all possible. Staff involved in the preparation of food have undertaken a bBasic food hygiene course. Ashwood Cheshire Home DS0000014378.V325750.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. There are good individual care plans for all residents that ensure their health is monitored and personal support is provided in an appropriate and sensitive manner. Lifestyle plans for each resident indicate what is important to them and for them, and ensures members of staff are aware of their emotional needs. EVIDENCE: Examination of the care plans showed that health matters are followed up and appropriate action taken. The specific needs of residents were discussed and there was a clear audit trail of doctors and specialist interventions. One resident said she was having her plaster cast off the following week. She explained that she had fallen in her room. This fall had been recorded and reported as an incident to the registering authority. Residents can visit the chiropodist and dentist as required. One resident had a very complicated eye operation and staff told the inspector what a celebrity she was in the hospital and how proud they were of the way she coped with the procedure, which was very complex. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 14 No resident is deemed capable to handle his or her prescribed medication. They each have a lockable medicine cabinet in their bedrooms, from which staff dispense from. A monitored dosage system is used and only staff who have received the appropriate training handle medication. Ashwood Cheshire Home DS0000014378.V325750.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. There have been no complaints made to the home or to the Commission for Social Care Inspection since the last inspection. The Registered Manager ensures that residents and members of staff have information in respect of abuse and how to report any allegations. There are robust procedures in place for managing residents’ finances these have been reviewed due to recent changes in legislation. EVIDENCE: There have been no complaints made to the home or to the Commission for Social Care Inspection since the last inspection. The complaints procedure is available and gives clear details and timescales for responding. Robust systems are in place for dealing with allegations or any sign of dissatisfaction. The Registered Manager ensures that residents and members of staff have information in respect of abuse and how to report any allegations of bad practice. Staff on duty told the inspector they had received training in the safeguarding of adults (POVA), and some had also received training in the protection of children. There are robust procedures in place for managing residents’ finances which have been reviewed due to changes in legislation (Mental Capacity Act). The Statement Of Purpose has been reviewed to show any changes to the service. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 16 Each resident has a contract with Leonard Cheshire and the sponsoring authority. A user-friendly licence agreement is prepared for each individual in a format tailored to learning disabilities. A regular internal audit is carried out, and the last results shown to the inspector were that the home had met 98 of its target. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 17 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. Ashwood Cheshire provides residents with an attractive comfortable home that is safe and well maintained. Residents’ rooms are individually decorated and provide a comfortable space for each resident. Sufficient toilets and bathrooms are provided. The communal space is comfortable and is attractively presented. EVIDENCE: The premises are in keeping with the local community. A tour of the home revealed clean comfortable accommodation. Resident’s rooms were personalised in a way that reflected their personality. There is one sharing room and this has been furnished and arranged in a way to provide each resident with the most possible privacy. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 18 The Registered Manager informed the inspector that a full Health and Safety assessment had been done in July 2006. Furnishing, fittings, and aids to promote independence and support residents with their daily tasks of living were in place. The laundry room leads off the kitchen, however the Environmental Health Officer has accepted this. Procedures are in place for the safe transfer of soiled clothing to prevent cross contamination. The home complies with the requirements of the Fire officer and Environmental Health Officer and no issues are outstanding. A member of staff, whose delegated duties are the upkeep fire procedures in the home, showed the inspector the fire records. All staff receive training as follows: six monthly for day staff, three monthly for night staff, and immediately for new staff as part of their induction training. Records examined and were found to be satisfactory. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 19 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. Members of staff have clearly defined roles and understand their responsibilities. Residents are supported and protected by an effective staff team who have received appropriate mandatory training and have had the necessary recruitment checks undertaken. Members of staff receive support and guidance from the Manager to ensure the residents’ needs are met in an appropriate and professional manner. EVIDENCE: There have been no new care staff employed since the home was last inspected in November 2005, therefore the inspector as part of the case tracking examined two files at random. Records contained therein complied with Schedule 2 of the Care Regulations. Supervision was also being carried out regularly as required. The inspector was present at change of shift and therefore had the opportunity to speak with four staff and interview two. Staff said that they had the opportunity to attend various training courses in relevant topics. They both had obtained either National Vocational Training Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 20 level 2 or 3 and one staff member told the inspector that she had been able to do a distance-learning course, which she has enjoyed. Four staff have completed National Vocational Training level 3 and a further three are participating in a course leading to this award. All staff have completed the learning disability award framework training (LADF) and the team leader is doing level 4 National Vocational Training. A matrix of training for 2007 was shown to the inspector. A qualified trainer employed by Leonard Cheshire provides the majority of training. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 21 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. The Registered manager is experienced and has the skills required to undertake the work. There is clear leadership and direction provided to members of staff that ensures residents receive a good quality of care and lead varied and fulfilling lives. The residents’ Health and Safety is promoted and protected. EVIDENCE: The Registered Manager holds a qualification in City and Guilds 325/3 in advanced care management, she is also currently undertaking the registered managers award. The staff reported that they felt supported by the management of the home. Staff meetings are regularly held to discuss the well being and daily running of the home. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 22 The home has a Quality Assurance policy in place and Leonard Cheshire carries out audits of the their services. No hazards were noted during this inspection. The Responsible Individual in respect of the company undertakes regulation 26 monthly visits to ensure the standards are being maintained. Records were securely stored and maintained to a good standard. Ashwood Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 23 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 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 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 Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 24 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 Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cheshire Home DS0000014378.V325750.R01.S.doc Version 5.2 Page 26 - 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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