Inspection on 14/02/06 for Ashwood House

This inspection was carried out on 14th February 2006.

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 House 04/02/08

Ashwood House 05/02/07

Ashwood House 12/07/05

Ashwood House 19/10/04

Ashwood House 27/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Ashwood House Church Corner, Coltishall Road Buxton Norwich Norfolk NR10 5HB Lead Inspector Mrs Lella Andrews Unannounced Inspection 10:20a 14 February 2006 th Ashwood House DS0000027521.V262000.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 House DS0000027521.V262000.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 House DS0000027521.V262000.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashwood House Address Church Corner, Coltishall Road Buxton Norwich Norfolk NR10 5HB 01603 279851 01603 279529 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) Jeesal Residential Care Services Limited Michelle Tebble Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eight (8) Service Users with Learning Disabilities may be accommodated who are aged over 18 years. 12th July 2005 Date of last inspection Brief Description of the Service: Ashwood House is a large, detached house in the village of Buxton, near Norwich. The house has parking to the front and a large garden to the rear. The Home is a few doors along from another Care Home owned by the same organisation. The Home is owned and managed by Jeesal Residential Care Services Ltd. It provides a service for up to eight adults with a learning disability. The Home has four bedrooms on the ground floor, two of which are ensuite, and four bedrooms on the first floor. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place between 10.20am and 1.30pm. The Manager was not present during the Inspection as she was off sick. The Support Services Manager was present for part of the Inspection. The Inspector spoke to three members of staff on an individual basis and to three of the tenants. The majority of the tenants living at the Home have communication difficulties and so it is difficult to obtain detailed information from them about their views of the Home. However, the Inspector spent the majority of the Inspection in the lounge/dining room and so was able to observe staff and tenants together. Only the communal areas of the Home were seen on this occasion. Several records were inspected. What the service does well: Staff know the tenants well and seem to genuinely care about them. They have a good understanding of the care plans in place to meet the tenant’s needs. Staff work hard to encourage the tenants to make their own choices about a variety of issues. Staff recognise that effective communication is vital and receive training with regard to alternatives forms of communication. Staff liaise with a range of professionals with regard to ensuring that the tenants physical and emotional health needs are met. Staff receive appropriate training, which enables them to carry out their roles effectively. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 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 House DS0000027521.V262000.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 House DS0000027521.V262000.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): None of these standards were inspected. EVIDENCE: The key standard has not been inspected in the last twelve months, as the Home has not admitted anyone new in that time. However, the Home has appropriate admission procedures in the event of a new tenant moving in. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 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 the following standard(s): 6 and 9 The care plans are detailed and contain guidance about how to meet the individual tenants needs but there is a need to ensure that all are up to date. Appropriate risk assessments are carried out as part of the care planning process. EVIDENCE: The Inspector looked at three of the care plans. These contain detailed information relating to the assessed needs of the individual tenants. The tenants have been encouraged to sign the care plans wherever possible to confirm their involvement in the process. The care plans contain information about the life history of the tenant, which enables the staff to have a better understanding of the individual. Information about the tenants likes and dislikes for a variety of issues is included in the care plans. The care plans are reviewed on a monthly basis and a record is kept of these reviews. However, one of the tenants care plans had not been updated and so, although there was evidence of a review, the actual guidance available to staff had not been updated and still reflected the plan of care that had previously been in place. The staff team have worked with the tenants for Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 10 some time and are aware of the correct plan of care but there is a need to ensure that the written plans are accurate to prevent any misunderstandings or inconsistent practice. The care plans contain detailed risk assessments with written guidance available for those areas assessed as being of a high risk to the individual tenant or to others around them. The staff are aware of the content of the care plans and risk assessments and the documents are used appropriately. One of the tenants told the Inspector that he knew what was in his care plan and gave permission for the Inspector to look at it. Ashwood House DS0000027521.V262000.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): 15 and 16 Tenants are given support to maintain contact with family and friends Tenants rights are respected and responsibilities recognised EVIDENCE: The care plans contain information about the arrangements in place for each tenant to maintain contact with their family and friends. Staff gave examples of how they assist the tenants to maintain contact, for example, by telephone and through sending birthday and Christmas cards and presents. Staff also provide transport and support to tenants to visit family if they are unable to come to the Home. Staff said that relatives are always welcome to visit the tenants and that some do so on a regular basis. The routines of the Home promote independence and individual choice. The staff are clear that the aim of the Home is to encourage the tenants to make their own choices and to maintain and develop their independence skills. Staff are aware of when the tenants need additional help and support. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 12 Tenants have unrestricted access to the house and the garden except for other tenants bedrooms. The tenants were seen to move around the Home freely. The layout of the lounge/dining area and conservatory is very open plan and so it can be difficult on occasions for individual tenants to find a quiet space within that area although they do always have access to their own bedrooms. The staff spend time with the tenants and encourage tenants to be involved in the general household tasks. Currently two of the tenants have some behaviours which impact on the other tenants despite the staff being aware of this and working hard to reduce the negative effects for others. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 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 the following standard(s): 18 and 19 Tenants receive personal support in the way that they prefer and require. The physical and emotional health needs of the tenants are met. EVIDENCE: The staff are aware of the individual tenants needs and the plans in place to meet those needs. The care plans contain information about individual preferences for how personal care is provided as well as preferences about other issues such as times for getting up and going to bed. The care plans contain information about how each tenant communicates and the staff work hard to use alternative forms of communication so that the tenants are able to make their own choices about a range of issues. It is clear that the tenants are enabled to make their own choices about their own sense of style and dress. One of the tenants was very pleased to have had her hair styled recently and her nails done. Female staff provide assistance to the female tenants. Risk assessments are in place with regard to the provision of personal care by a member of staff of the opposite gender. The care plans contain detailed information about the tenants physical and emotional health needs. There is evidence that tenants are supported to attend routine appointments such as opticians and dental as well as for other, Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 14 more specific appointments with psychiatrists, psychologists, speech and language therapists etc. As previously mentioned in this report, two of the tenants have particular health needs which are causing changes to their behaviour. The Inspector saw records of meetings, which show that these situations are being addressed within a multi disciplinary situation and that action is being taken to reduce the negative effects on the other tenants. However, the information was not all updated within the care plans and there is a need to ensure that all of the staff have up to date information so that they can provide consistent support to the tenant and so that the staff team feel confident that their concerns are being listened to. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The tenants are given opportunities to raise any concerns that they may have and these are addressed. Procedures and staff training all contribute to protecting the tenants from any form of abuse. EVIDENCE: The Home has a complaints procedure which is also available in symbol format for the tenants. The tenants may find using a formal procedure difficult but there are a range of ways in which the views of the tenants are sought. There is a weekly tenants meeting at which a range of issues is discussed and the tenants given the chance to raise any concerns that they may have. Tenants meet with their key workers on an individual basis monthly to review their care plan and any outstanding actions from the previous month. Staff spend time with the tenants throughout the day and were heard to ask for the tenants views about a range of issues. Staff are aware of the complaints procedure and of the action that they would take if someone wished to make a complaint. All staff receive training with regard to the protection of vulnerable adults within their induction and then this training is expanded during the formal training session about this subject that all staff attend. The staff who spoke to the Inspector were clear about their responsibility to report any concerns of possible abuse and were confident that the Manager and organisation would deal with the situation appropriately. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 16 The care plans contain information relating to physical and verbal aggression shown by a tenant as appropriate. Staff receive training with regard to working with tenants who have behaviours which challenge. The staff were seen to work with tenants in a consistent manner with regard to their behaviour. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected EVIDENCE: Although none of these standards were inspected it was noted that the garden has received attention and is now an attractive area for the tenants to use. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36 The tenants are supported by competent and qualified staff who receive appropriate training. Staff receive support but there is a need to ensure that all staff receive formal supervision. EVIDENCE: The Inspector was unable to check the recruitment records as the Manager was not there and they are kept securely due to confidentiality. The staff said that they have received a good level of training which has been effective and beneficial to them when carrying out their roles. The training includes induction, fire safety, first aid, food hygiene, communication, epilepsy, behaviour, medication, NVQ. The organisation has its own accredited training department and so is able to also provide NVQ training for the staff team. The Inspector was told that the Manager has recently planned the formal supervision and team meeting dates for the forthcoming year. This sounds a positive step as formal supervision has not taken place for all staff on a regular basis. The staff said that they receive informal support on a daily basis and that they are aware of how to contact the on call support if necessary. Annual appraisals have recently taken place. It is recommended that all staff receive formal supervision on a bi monthly basis. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The health, safety and welfare of tenants and staff are protected. EVIDENCE: The Inspector was unable to form an accurate view of the effectiveness of the management of the Home as only two staff were interviewed and the Manager was not present during the Inspection. This issue will be looked at during future Inspections. The Inspector saw a selection of records, which showed that the fire safety equipment and the gas provision are regularly serviced and that staff receive appropriate fire safety training as well as taking part in drills. It is recommended that the names of the staff taking part in fire drills is recorded so that the Manager can ensure that all staff take part in at least two per year. Risk assessments are in place in relation to fire safe (although this is fairly brief) and for the general environment. Regular health and safety monitoring checks are carried out within the Home. As previously mentioned, the care plans contain individual risk assessments relating to the tenants. Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 20 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X 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 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X X 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood House Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000027521.V262000.R01.S.doc Version 5.0 Page 21 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. 1 2 3 Refer to Standard YA19 YA32 YA42 Good Practice Recommendations It is recommended that the care plans are updated as soon as situations change in relation to the tenants care It is recommended that all staff receive formal supervision bi-monthly It is recommended that the record of fire drills records the names of staff taking part Ashwood House DS0000027521.V262000.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 House DS0000027521.V262000.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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