Inspection on 08/06/05 for Ashwood Cheshire Home - Leonard Cheshire Disability

This inspection was carried out on 8th June 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.

Other inspections for this house

Ashwood Cheshire Home - Leonard... 11/01/07

Ashwood Cheshire Home - Leonard... 18/11/05

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

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

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 J Aston Announced 8 June 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 Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Ashwood Cheshire Home Address 141 Chesswood Road, Worthing, West Sussex, BN11 2AE 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) 01903 230930 01903 239878 Leonard Cheshire Mrs Gillian Donovan CRH(PC) Care home only 8 Category(ies) of LD Learing disability- 7, LD(E) Learning registration, with number disability over 65 years of age 1 of places Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 1 person in the category LD(E)(learning disability over 65 years to be accommodated. 2. Up to 7 maleand /or female service users in the category Learning disability may be accommodated. 3. Only service users aged between 18 and 65 may be admitted. 4. A maximum of 8 service users may be accommodated. Date of last inspection 4 November 2004 Brief Description of the Service: Ashwood Cheshire Home is a care home registered to accommodate up to eight service users in the category LD, to include one person over the age of 65 years, LD (E).It 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 the seafront. The property is an attractive double-fronted two-storey building that stands in its own grounds in a street of similar properties. Bedrooms are located on both the ground and first floors.The Leonard Cheshire Foundation privately owns the service. The Responsible Individual acting on behalf of the organisation is Mr Peter Bray. Mrs Gill Donovon is the Registered Manager. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and undertaken on Wednesday 8th June over eight hours from 10am to 6pm. Two residents were present in the home during most part of the inspection. All residents were present in the home at around 3.30pm. The Inspector was unable to speak with all residents to obtain their views of the home due to their level of disability and communication difficulties. However observations were made of the interaction between members of staff and residents. Five members of staff were spoken with during the inspection. Comment cards were sent to the home to distribute to relatives and residents. Three were received prior to the inspection. The Inspector examined records kept in the home in relation to three residents, risk assessments, training records, records relating to new members of staff and Health and Safety documentation. The Inspector also looked around the home. What the service does well: What has improved since the last inspection? A number of new members of staff have been recruited to provide a full complement of staff and relief staff. New sofas have been purchased for the lounge and new dining tables and chairs for the dining room. A new boiler has been fitted. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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 Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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) None The Standards in this section were not assessed at this inspection. EVIDENCE: Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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, 8, 9. 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: The Inspector examined individual care plans for three residents. All care plans had been reviewed regularly and provided detailed information about the needs of each resident. Specific guidelines were in place in respect of how staff should work with those residents who may present with challenging or inappropriate behaviour. Each resident keeps a lifestyle plan in their rooms that records information that is important to them. Members of staff spoken with confirmed that the information recorded about each resident provides them with comprehensive and clear guidance on how to Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 10 work with each resident. They confirmed that the staff team work in a way that helps residents to make choices about everyday things in their lives but also in a way that increases their independence. A member of staff said, “When I came to work here I was surprised at the freedom of choice residents had.” Another said “It is their home its relaxed not institutional, they choose how they spend their time.” It was observed that residents are supported to participate in cooking and other activities that may promote their independence. Risks to residents are considered before they participate in an activity and the action to be followed to lessen the risk is recorded on a risk assessment. Risk assessments are reviewed regularly. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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) 11, 12, 13, 14, 15, 16. 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: Most residents attend local day care facilities where a variety of activities are offered. Some residents also attend a local college. Music sessions are provided in the home on a weekly basis, keep fit on a monthly basis and a PAT dog visits the home on a regular basis. Members of staff support residents to visit local shops, garden centres and restaurants. Residents have organised holidays or day trips out. Older residents have been supported to have a more relaxed lifestyle with more time in the home. A resident said that she had retired and was happy with her time spent in the home. “I go out for coffee, go to Garden Centres and do my knitting.” Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 12 Some residents visit relatives on a regular basis or relatives visit the home. It was observed on the day of the inspection that residents were involved in the preparation and cooking of snacks and the main meal of the day. A resident said “I unload the dishwasher, lay tables at meal times, make drinks and cook cakes.” Members of staff confirmed that residents where able make tea, coffee and other drinks and are involved in laying tables, clearing away after a meal and cleaning their rooms. The home promotes healthy eating and residents’ diets and weight are monitored. All relatives who returned comment cards said they were satisfied with the service and care provided. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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, 19 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: A sample of three individual plans was seen all of which had good details about the health needs of each resident. A record of appointments for the chiropodist, dentist and Doctor were also recorded and treatment or advice for any health problems noted. Where a resident has an accident this is recorded appropriately. Most residents require supervision with personal care and assistance with bathing or showering. The individual plans provide good guidance on how this support should be offered and provided to ensure a resident’s independence is promoted and maintained. A resident said “I like all the staff and they are kind when they help me” Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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) 23 There are robust procedures in place for managing residents’ finances however these require reviewing due to changes in legislation. EVIDENCE: Some residents require the assistance of the home in managing their financial affairs. All residents have their own bank or building society accounts but may require support to deal with benefits, budgeting, paying in money or withdrawing money from their accounts. The organisation and home have good procedures in place to ensure the safe handling of residents finances and they are audited regularly. However due to changes in legislation recently through the Mental Capacity Act 2005 it is recommended that the organisation and home should review their procedures to ensure that they are working in line with the requirements of this piece of legislation. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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, 25, 26, 27, 28, 29, 30. Ashwood 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 has recently been refurbished. EVIDENCE: The Inspector looked around the home and garden during the inspection. The home was well maintained and decorated and clean. The recent Fire Officer’s report was satisfactory. Residents’ rooms are decorated in a bright and comfortable way with residents’ belongings personalising each room. A resident said, “I like my room it is comfy” Two residents share a ground floor room. This has been a long-standing arrangement and members of staff said that each resident appears satisfied with this arrangement. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 16 Improvements are planned for the ground floor bathroom to refurbish and improve access particularly for older residents. The lounge and dining areas have been improved with new furniture. The garden looks reasonably well maintained and is accessible and safe for residents. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 17 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) 31, 32, 33,34,35,36. 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: From the records examined it was clear that new members of staff had received job descriptions and have had the necessary references and Criminal Record Checks undertaken prior to employment. The home has now has a full compliment of staff and a number of relief staff employed. All members of staff spoken said that staffing levels had improved and they now had more time to spend with residents. Training records demonstrated that the organisation provides a corporate induction programme for new members of staff. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 18 The home provides a practical introduction to the home and new members of staff shadow other members of staff before working alone. New members of staff spoken with said that the induction programmes provided good and clear information and they felt well supported in the early stages of their employment. Members of staff said, “we are a stable staff team, we support one another and we work well together, we are a close team.” The organisation provides a rolling programme of mandatory training topics such as moving and handling, food hygiene, first aid etc and refresher training in these topics to keep staff up to date. Training in National Vocational Qualifications is also provided. However specific training in working with people with learning difficulties is not currently provided. The manager and members of staff confirmed that this is being looked into by the organisation. All members of staff spoken with said they received individual supervision sessions on a regular basis and attended staff meetings. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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 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) 37, 38, 40, 42. 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: Members of staff spoken with said that the Manager of the home was approachable and provided opportunities for members of staff to raise concerns or suggestions. The documentation held in the home in relation to safety checks of gas, electricity, fire prevention and equipment was in good order and up to date and proved that the Manager ensures that the residents live in safe environment. The organisation has provided all of the necessary policies and procedures. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 20 Members of staff said that mandatory training in Health & Safety topics is provided on a regular basis. Recently all staff had undertaken training in fire prevention and procedures, first aid and protection of vulnerable adults. All members of staff spoken with said that they were alert to recognising new risks to residents in the home and reported these promptly. Members of staff said they felt well supported and there is always a manager on call in the evenings and weekends. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 Ashwood Cheshire Home 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 Version 1.20 Page 22 H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 3 x Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 23 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. 1. 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. 1. 2. Refer to Standard 23 6 Good Practice Recommendations The organisation and home should review their procedures in respect of managing residents finances. Lifestyle plans should be reviewd and updated where necessary. Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Ashwood Cheshire Home H60-H11 S14378 Ashwood Cheshire Home V221754 080605 stage 4.doc Version 1.20 Page 25 - 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!