Inspection on 17/08/05 for Ashwood House

This inspection was carried out on 17th August 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood House 29/03/07

Ashwood House 08/02/06

Ashwood House 24/02/05

Ashwood House 15/06/04

Ashwood House 03/03/04

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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 House 217 Winchester Road Southampton Hants SO16 6UA Lead Inspector Liz Normanton Unannounced 17 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ashwood House Address 217 Winchester Road, Southampton, Hants, SO16 6UA 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) 023 8077 7451 Wessex Regional Care Ltd Miss Zoe Coral Russell Care Home 5 Category(ies) of Learning Disability (LD) registration, with number of places Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 February 2005 Brief Description of the Service: Ashwood House is located on the outskirts of Southampton on a busy main road. The home provides care and support for up to five people who have a learning disability. Currently all the service users are male. The aim of the home is to support residents to develop social, daily living and independence skills to become integrated into the community. Twenty-four hour staff support is provided. The house is detached and it has a sitting room, dining room, spacious kitchen and bathroom on the ground floor. Bedroms are situated on the first floor and are single rooms which are spacious and have been personalised to each service users own preference.There are no en-suite facilities, however there is a bathroom on the first floor which is accessible from all the bedrooms. Car parking is available to the side of the house and there is a large well maintained garden to the rear, which offers privacy. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and was the first in the inspection year. The inspector arrived at the home around mid morning and was greeted at the door by two of the residents. Two staff were on duty caring for three residents. The manager of the home arrived later in the day before lunchtime. Throughout the day the inspector observed residents in their daily activities, one resident was seen to be engaged in household tasks as part of their personal development. One resident was seen to spend time relaxing outside in the garden prior to going out to the park for the day. Interactions between the staff and residents was seen to be very positive. The inspector undertook a full tour of the property and found that there had been recent redecoration of the lounge, however the seating in this room was found to be showing signs of wear and tear. One resident’s bedroom carpet was worn and threadbare. Overall the home was kept clean and tidy, however there was an odour present in the downstairs toilet. The manager explained that they are having difficulty eliminating this odour. There was evidence that the room had been cleaned and air fresheners were present. The kitchen was found to be clean, however the food preparation boards were well used and had become discoloured and were considered to be a risk. The inspector had the opportunity to spend time with three service users independently, and the overall opinion is that they enjoy living at the home and felt well supported by staff. Service users also confirmed that they can make choices and have access to activities and are part of the local community. The inspector spent the majority of the day consulting with the manager, looking at records and examining files and found that most of the standards assessed had been met. The overall impression was that the service users needs are put first and foremost by the manager and staff team. What the service does well: The manager ensures that prospective residents’ needs are assessed prior to admission. There is a well-established staff team who have experience of working with service users with learning disabilities and mental health problems. Prospective residents are positively encouraged to visit the home on several occasions to enable them to make an informed choice as to whether they wish to move in. Residents are able to make decisions in all aspects of their life. There are regular resident meetings to discuss issues within the home and to enable residents to make service requests. Residents are able to take risks. There are opportunities to engage in leisure activities inside and outside the home. Residents are well supported to maintain relationships with Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 6 family and friends. The home is very spacious and allows opportunities for residents to have privacy. 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 H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 and 4 Written information about the home is available for prospective service users to make an informed choice about whether the home would meet their needs and expectations. However prospective service users would benefit from a more detailed service users guide. The home’s manager undertakes a detailed needs led assessment with prospective residents from which a care plan is formulated which identifies their individual needs. The home’s manager endeavours to assure prospective residents that the home will try to meet their needs and aspirations. All prospective residents are welcome to visit the home during the decision making process. EVIDENCE: The home has a Statement of Purpose however the existing service users guide has limited information. The manager has undertaken a comprehensive needs assessment of a prospective resident, which was viewed by the inspector and was found to be satisfactory. The assessment was compiled with information provided by the prospective resident and their care manager during meetings, and a service user plan has been formulated. The inspector viewed two additional service user plans and found them to have detailed information and that they were written in the first person. The inspector observed support staff having positive Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 9 interaction with residents throughout the day. Three residents are offered additional support from the consultant psychiatrist at the hospital on a three monthly basis. The home employs seven care staff, and at present two staff are at work on each shift over a twenty-four hour period. In discussion with the manager the inspector learned that she would not consider having anyone move into the home if their needs could not be met. There are plans for the prospective resident to move to the home at the beginning of September and he has visited the home once for a day and there are further plans for him to visit prior to moving in. The home offers a three month trial period after which a review is held. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 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 standard(s) 7,8 and 9 Residents are able to make decisions about the way they wish to live their lives. Residents are actively encouraged and supported to participate in the day–to-day running of the home. Residents are allowed to take risks as part of promoting an independent life style. EVIDENCE: Throughout the day the inspector made several observations and noted that residents were able to make choices about how they wanted to spend their time. Three residents were at home during the inspection and one chose to go out to the pub for lunch, whilst two others decided that they would like to go out to the park. The residents are encouraged to take part in reviewing their service user plan, and the inspector noted that decisions they had made were recorded about their likes and dislikes and whether they would participate in household tasks. The inspector interviewed three residents who confirmed that they are allowed to make choices about what they want to wear, how they spend their money and what they want to do during the day etc. The inspector learned from discussion with the manager that one resident has been allocated an independent advocate. The inspector observed one resident being involved in cleaning the home as part of his independent living skills development. Residents do not contribute to the development and review of the home’s policies and procedures, however the inspector saw the minutes of residents’ Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 11 meetings, which are held once a fortnight, and their views are taken into consideration by the staff and management. The inspector noted that one resident had decided not to attend the meetings. Residents are allowed to take risks inside and outside the home. One gentleman goes out independently in the community on his cycle, another visits the local post office without support. One resident has a kettle in his bedroom to enable him to make drinks independently from the group, which was at his request. Each resident has an independent comprehensive risk assessment, service users are involved in assessing the risk. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 12 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) 14,15 and 17 Residents are able to engage in appropriate leisure activities in the course of their daily living. The ethos within the home supports residents to maintain existing relationships and develop new ones. Residents are provided with healthy nutritional meals and are involved in meal choices. EVIDENCE: The home is equipped with a television and video/dvd player to provide inhouse entertainment. There is also a sound system. Individuals have their own personal equipment in their rooms. The home has an annexe which is called the UcanDo room. This room is equipped with a computer, outdoor games equipment such as skittles, kites, bats and balls etc, board games, and art and craft materials. There is also a Karaoke machine and sound system. There are plans to take residents on holiday, two to Oxfordshire and two to Ireland. One resident has a year pass to the local football ground and staff support him to go on a one-to-one basis. The home has its own vehicle. Discussion with the manager and staff indicated that residents are supported to maintain relationships with family and friends, and this was confirmed by residents. The inspector looked at the menus, which were well planned and the meals provided are nutritional and healthy. A list of residents likes and dislikes Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 13 of food stuffs was on display in the kitchen to inform staff. One resident told the inspector that he shops for food with the staff and is able to make choices about meals. In discussion with the manager the inspector learned that mealtimes are relaxed, with residents being able to choose where they eat. Tea time can be anytime between 4.00 pm-7.00 pm, and residents are encouraged to participate in food preparation. The home keeps a record of residents’ daily dietary intake. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 14 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 and 20 Care staff provide personal support to residents, as required, in such a way as meets their needs and preferences. The home meets the health care needs of the residents. The home has medication policies and procedures to safeguard the welfare of the residents. EVIDENCE: The majority of the residents do not require personal support, as they are able to care for themselves. Assistance is given as required, and the details of care are written into individual care plans. Three of the residents have an allocated key-worker who can provide a level of consistency and continuity of support. The inspector noted that the home does have a bath aid. The inspector spoke with two residents who stated that they are able to choose what times they get up and go to bed, what clothes they wear and what hairstyles they prefer. The manager stated that three residents go out to the local barber whilst one has their hair cut at the home. A chiropodist visits the home approximately every six weeks. The inspector noted that each resident was registered with a GP at the local surgery. For those residents with mental health problems the manager informed the inspector that they were examined regularly by the consultant psychiatrist. Residents are given six monthly health checks. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 15 The home has a copy of the medication policy and procedure to inform staff. Medication was found to be stored appropriately, and records of medication administered were recorded on Mars charts. All staff have been trained in the administration of medication, training certificates were observed. Medication is provided from the chemist in blister packs, and the inspector counted two residents’ medication against details on the Mars chart and found them to be accurate. The inspector noted that the home had a copy of the BMA guide to medicines and drugs and an A-Z of symptoms. The manager had undertaken a COSHH risk assessment in relation to medication stored at the home which indicates any risk to staff. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents are encouraged to put across their views about the service and there is a complaints procedure in place. EVIDENCE: The inspector viewed the home’s policy and procedure with regards to the management of complaints and found that they did not have the correct information with regard to the registering body, which was still recorded as NCSC. The manager altered this information immediately to CSCI. The home keeps records of complaints which was seen by the inspector, and there have been no complaints made since the last inspection. The inspector spoke with three residents two stated they had no complaints, whilst one was not happy with part of the service. This was discussed with the manager who was aware of the circumstances which had previously been addressed with the resident. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 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 standard(s) 25,26,27,28 and 30 Residents’ bedrooms reflect their needs and lifestyles and promote their independence. The home provides each resident with sufficient toilets and bathroom facilities to ensure privacy. The home provides spacious shared communal space, which supplements their rooms. Overall the home was found to be kept clean and hygienic except for the downstairs toilet/bathroom, which had a strong offensive odour. EVIDENCE: The inspector viewed all five bedrooms and found them to be spacious. All bedrooms were fitted with a wash basin. Two bedrooms had been re-decorated this year between March and July. The vacant bedroom requires redecorating and in discussion with the manager the inspector learned that there is funding available for the prospective resident to have the room to decorated to his taste following admission. The four bedrooms currently occupied were seen to be individualised and reflected the individual’s tastes and interests. One bedroom was found to have a worn carpet. All bedrooms were furnished to meet requirements and the majority of the furnishings were the residents’ own property. All bedrooms are fitted with locks and all residents are provided with Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 18 a key. The home has two toilet facilities one on the ground floor and one on the first floor, locks are fitted to both toilets/bathroom/shower rooms. The home has a spacious lounge, kitchen, dining-room and garden which residents can share. There is a separate staff bedroom. The lounge was redecorated in July 2005 and was found to be decorated to a high standard, however the seating has not been replaced for some years now and the springing and cushioning was found to be showing significant signs of wear and tear, which could lead to poor posture for residents. The home’s laundry is situated away from the kitchen. The COSHH cupboard is located in the laundry. The laundry floor is impermeable and the washing machine washes to the required temperature. The inspector noted that there were sufficient hand washing facilities situated within the home and were suitably sited, and staff were supplied with liquid soap and paper towels to prevent the spread of infection. The home has hygiene and control policies and procedures in place for staff to follow. Staff have been trained in Health and Safety and one member of staff has had training in infection control. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Five of the above standards were assessed at the previous inspection and were met. EVIDENCE: Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 20 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) 41 Residents rights and best interests are safeguarded by the home’s record keeping policies and procedures. EVIDENCE: The inspector did not view all records kept within the home but was satisfied that appropriate records are maintained and are in accordance with the Data Protection Act. The inspector viewed residents’ care plans, medication records, accident records, staff files. All documents were kept in lockable cabinets. Ashwood House H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 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. 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 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 2 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x x 4 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood House Score 3 3 4 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 x x H55-H03 S36881 Ashwood House V220735 170805 Stage 4.doc Version 1.40 Page 22 N/A 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 YA 1 Regulation 5 (1) Requirement Timescale for action 20/11/05 2. YA26 3. YA42 The home is required to produce a service user guide which details all the information as required in reg 5 16 (2) ( c) The home is required to purchase new seating for the lounge and replace worn bedroom carpet. 16 (g) Replace food preparation boards 31/10/05 Immediate action required. 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. 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