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Inspection on 18/11/05 for Ashwood Cheshire Home - Leonard Cheshire Disability

Also see our care home review for Ashwood Cheshire Home - Leonard Cheshire Disability for more information

This inspection was carried out on 18th November 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Care provided for residents is of a good standard. Care plans are detailed and enable staff to have a clear understanding of each resident`s individual needs. Residents are offered a wide range of activities and learning opportunities. Those who wish can access day centres during the week and in the evenings can attend clubs.

What has improved since the last inspection?

Since the last inspection one bathroom and toilet has been upgraded. Residents individual lifestyle plans have been updated, and advice has been sought regarding management of resident`s finances. Mrs Donovan was advised that the requirements of the Mental Capacity Act 2005 do not affect their current procedures. However the inspector was advised that regular audits of resident`s finance now take place.

What the care home could do better:

The home continues to provide residents with a good standard of care that enables them to develop and maintain independent lifestyles within individual capabilities. However due to some of the comments highlighted from the relatives comment cards it would be good practice for the management to address those areas where relatives feel that the home does not meet their expectations.

CARE HOME ADULTS 18-65 Ashwood Cheshire Home 141 Chesswood Road Worthing West Sussex BN11 2AE Lead Inspector Mrs S Rodgers Unannounced Inspection 18th November 2005 03:00 Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 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.V257442.R01.S.doc Version 5.0 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.V257442.R01.S.doc Version 5.0 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 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) Leonard Cheshire Mrs Gillian Donovan Care Home 8 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (1) of places Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of 1 person in the category LD(E) (learning disability over 65 years) to be accommodated. Up to 7 male and/or female service users in the category Learning Disability may be accommodated. Only service users aged between 18 and 65 may be admitted. A maximum of 8 service users may be accommodated at any time. Date of last inspection 8th June 2005 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 one person 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.V257442.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two afternoons. The total number of hours the inspector was within the home was 5. Planning for this inspection included reviewing the previous inspection report and general correspondence. Comment cards were also sent to the home to enable residents and relatives to comment on services provided. At the time of writing this report the inspector was in possession of 6 completed questionnaires, 2 from residents and 4 from relatives. Both residents who responded indicated that they were happy with the service provided. Relatives comments were mixed, one relative felt that they were not kept informed or consulted re their relatives care and that they did not always feel welcomed into the home, however generally relatives are satisfied with the overall care provided. Two relatives indicated that they have not been informed of the homes complaints procedure and two felt that there is not always enough staff on duty. During the course of the inspection the inspector toured the home and reviewed records. The majority 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. What the service does well: What has improved since the last inspection? Since the last inspection one bathroom and toilet has been upgraded. Residents individual lifestyle plans have been updated, and advice has been sought regarding management of resident’s finances. Mrs Donovan was advised that the requirements of the Mental Capacity Act 2005 do not affect their current procedures. However the inspector was advised that regular audits of resident’s finance now take place. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 6 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 Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 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.V257442.R01.S.doc Version 5.0 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): 1,2,3,4,5 Residents or their representatives are provided with information about the service. The pre admission process ensures that staff, relatives, placing social workers and residents know that the care needs of the perspective resident can be met by the home prior to them being admitted. The admissions process does encourage trial visits. Each resident has a written contract/statement of terms and conditions with the home. EVIDENCE: The Statement of purpose clearly outlines the services provided. This enables residents and/or their representatives to make an informed decision as to whether the service can meet their individual needs. The Statement of Purpose is in written text and the Service User Guide is in symbol form. Each resident has a contract that is also in symbol form. Although residents have lived at Ashwood for a number of years staff were able to demonstrate that an admissions process is undertaken. Pre admission documentation held on one resident’s file clearly demonstrates that the resident’s individual needs and aspirations are assessed prior to them moving into the home. Records are kept of the admission process i.e. the visits made by staff to prospective resident’s and resident’s visits/short stays at the home. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 9 The admission process is not the same for each resident. The needs of the individual determines the length of the process and how many pre admission visits they have prior to admission. Trial visits to the home are encouraged, the number of visits prior to moving into the home varies from resident to resident. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 Information about residents is appropriately handled. EVIDENCE: 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.V257442.R01.S.doc Version 5.0 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): 17 Resident’s benefit from a well balanced diet. EVIDENCE: Menus reviewed at the inspection indicated that resident’s are offered a balanced and varied diet. Resident’s who were able told the inspector that “the food is good” and that “we get enough to eat”. Meals are generally taken in the dining room. Staff are in the process of developing an 8-week rolling menu. It is also their intention to make a pictorial board so that residents can see what meals are on offer each day. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 12 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): 20, 21 Systems are in place for dealing with medicines. Policies are in place to ensure that residents are treated with respect during the ageing process, illness and death. EVIDENCE: The home has a pharmacy agreement with a local chemist who visits the home twice a year to review the systems and storage of medication. Staff who administer medication have had training provided by the pharmacist. Records seen of the receipt, recording, storage, handling, administration and disposal of medication were in good order. The homes policy and procedures for ageing, illness and death of a resident advise staff of how to ensure that residents are handled with respect and that individual wishes are carried out. An example of residents wishes being taken into account with regards the ageing process is that the one resident who is over the age of 65 does not attend college or day centres at her own request. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 13 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 Residents are able to raise concerns via the homes complaints procedure. EVIDENCE: The home has a written complaints procedure that advises residents and relatives of what action they should take if they wish to raise concerns. The Procedure includes timescales for action and the address of the local office of the Commission. Mrs Donovan advised the inspector that she has recently sent out the organisations complaints procedure. In light of the comments from some relatives it may be appropriate to ensure that all relatives received a copy. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 14 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): These standards were not assessed at this inspection as they were reviewed at the previous visit and were met in full. EVIDENCE: Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 15 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): 33 An effective staff team supports residents. EVIDENCE: There were two staff members on duty on the first day of inspection and two on the second day, in addition the registered manager was present on the second day. Both staff members have worked within the home for a significant number of years. At both visits the two staff members were observed to be relaxed and confident whilst carrying out their duties. Staff were respectful towards residents and were fully aware of residents individual needs. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 16 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): 39,41 A quality assurance and monitoring system is in place. Records are maintained in good order and appropriately stored. EVIDENCE: The home has undertaken a quality assurance and quality-monitoring audit. The written outcomes were available at this inspection. The inspector was advised that residents who were able, relatives and other stakeholders were asked their view of the service. Auditors also checked record keeping systems with in the home. Records required to be kept by legislation were available. Care plans were up to date and were appropriately stored with in lockable boxes within resident’s own rooms. Records of financial transactions made on behalf of residents were available and appropriately stored. All records seen appeared in good order. Ashwood Cheshire Home DS0000014378.V257442.R01.S.doc Version 5.0 Page 17 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 3 3 3 3 3 Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood Cheshire Home Score x x 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 x x DS0000014378.V257442.R01.S.doc Version 5.0 Page 18 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.V257442.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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