Inspection on 04/02/08 for Ashwood House

This inspection was carried out on 4th February 2008.

CSCI found this care home to be providing an Good service.

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 05/02/07

Ashwood House 14/02/06

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 Ginette Amis Unannounced Inspection 4th February 2008 12:15 Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood House Address Church Corner, Coltishall Road Buxton Norwich Norfolk NR10 5HB 01603 279851 01603 279529 a.jeesal@virgin.net www.jeesal.org Jeesal Residential Care Services Limited 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) Appointed Manager Ms Nicola Atkin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eight (8) Service Users with Learning Disabilities may be accommodated who are aged over 18 years. 5th February 2007 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 six bedrooms on the ground floor, two of which are ensuite. The upper floor has recently been converted into a self-contained apartment with two bedrooms, a bathroom, kitchen diner and lounge. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality Rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place on Monday 4th February 2008 from 12: 15 to 17:15. The appointed manager, though attending a meeting at another of the organisation’s care homes nearby made herself available through the day and together with the deputy manager was helpful and courteous in supplying information about the service. There were four other members of staff on duty during the course of the day and all were welcoming and helpful. Two of the organisation’s senior managers called into the care home during the day and were equally welcoming. A number of people who lived at the care home were present during the day and while verbal exchanges were limited, all these people appeared well cared for and content and it was evident they enjoyed good relationships with the different members of the staff team. There were no visiting relatives or friends at the care home on the day of the inspection but 2 relatives had completed comment cards sent them by CSCI and another was contacted by telephone and asked their opinion of the service. What the service does well: Offering accommodation to only 8 people, Ashwood House in many ways resembled a family home. The small scale of the premises enabled people living there to relax and grow familiar with their surroundings, the staff team and fellow tenants with minimal possibility of becoming ‘lost’ there. Members of staff had extensive knowledge of the tenants, were competent at communicating with them, even in the absence of speech and able to read their body language and moods. This familiarity greatly enhanced the exchange of information between tenants and staff, so that staff could respond quickly in situations that might otherwise become tense. The atmosphere at the care home was friendly and tolerant. Tenants were encouraged to spend their time in ways that pleased them and made the most of their abilities. The service providers had ensured the staff team was well equipped to fulfil their roles by offering a useful range of training opportunities. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5. Quality in this outcome area is good. The Service User Guide contained all the essential information about the service that anyone considering admission there might need. It would have been helpful to prospective tenants had this Guide also been produced in an ‘Easy Read’ version. People were only admitted to the care home once their needs had been assessed and it was clear the service was right for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ashwood House made available an informative Service User Guide that gave a comprehensive over-view of the services provided at the care home. Copies of the statement of purpose, complaints procedure, terms and conditions of residence and contractual agreement were included in this document. We (Commission for Social Care Inspection) found that each of the tenants (residents are known as tenants at Ashwood House so the term has been adopted in this report) had been issued with their own copy of the Service User Guide. These Guides contained information pertinent only to the individual they belonged to, for example the contract contained the charges for that person and the room allocated them had been identified. Five such Guides were examined. The contracts contained in each had not been signed, either by the resident, their representative or a representative of the care home. The manager was aware of this discrepancy and a Recommendation Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 9 was made for this agreement to be validated by signatures as soon as possible. The Service User Guide was usefully informative for prospective tenants and their families, Social Workers or Health Care professionals. The Guide is provided as an audio cassette as well if requested. The files of 6 tenants were examined and found to contain evidence of an in depth assessment of the needs of each person concerned. The manager explained how many of the tenants had come to live at Ashwood House having first lived in another of the Organisations’ Care Homes where, through a process of on going assessment, Ashwood House was confirmed as the more appropriate accommodation capable of meeting their individual needs. There were 7 people in residence at Ashwood House and preparations were being made for the arrival there of an 8th person. The prospective new tenant was currently living in one of the organisations’ near by care homes and was already familiar with Ashwood House, its’ staff and existing tenants. Prospective tenants were routinely invited to make several visits to Ashwood house before deciding to live there. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. Quality in this outcome area is good. Care plans contained detailed information that reflected the personality, preferences and aspirations of tenants together with guidance for staff as to their support needs. The care home regularly consulted with tenants to ensure that their expectations were met. Risks were appropriately assessed and staff given clear guidelines on how to minimise their potential while still enabling tenants to participate in events. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of 6 of the tenants were examined. We (CSCI) found each file contained a useful pen-picture of the tenant and a summary of the support they required and means by which the care home would provide that service. This section was followed by in depth assessment of a range of personal needs, including health and personal care, social and emotional wellbeing, as well as general likes and dislikes. Communication skills had been evaluated and guidelines provided for members of staff to enable them to understand both verbalised communications and body language. Risk assessments Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 11 addressed concerns over personal safety and included an overview of situations when that tenant might potentially encounter hazards and the means by which risk could be managed or averted. Difficulties with mobility had been carefully considered and guidance given staff over the use of assistive equipment and the procedures to follow to enable the tenant to maximise their abilities. Files contained evidence that daily events were recorded and summarised at the end of each month. While all 6 of the files examined were detailed in approach, there were sections in some that were in need of review. The manager was aware of this and where tenants’ needs were due to be reassessed the relevant sections of those care plan had already been marked in preparation. A Recommendation was made for this work to be completed as quickly as possible. The manager had recently completed training in relation to the way the Mental Capacity Act 2005, since coming fully into force in October 2007, impacted on how services should be delivered and was aware that the review process would need to include a re-evaluation over how tenants were enabled to make decisions. Arrangements had been made for additional members of the staff team to be similarly trained to understand how the Act might affect the way they worked with tenants. Tenants had an individual Finance Care Plan in which the way any cash being held in safe keeping for them by the care home was appropriately documented. This plan included a section produced in a user-friendly format. The manager sought to include tenants in the daily running of the care home by holding regular weekly meetings with the tenants as a group. Minutes taken of such meetings showed how daily events were discussed. The group was enabled to plan for the following days’ activities, choose and set the menus as well as air any associated concerns or problems they might be experiencing. The manager would use this as an opportunity to ensure tenants knew of any possible unusual events, such as builders or maintenance workers being expected to visit the care home. The organisation responsible for running the care home in addition held ‘Residents’ Forums’, a meeting of tenants or their representatives from a number of care homes operated by them with a view to gaining feedback on tenants’ experience of living in a Jeesal Care Home. During the course of the inspection staff were observed interacting with tenants. They offered tenants choices over how to spend their time and with regard to making preparations for the evening meal. It was also evident, during the course of a number of occurrences, how members of staff had good understanding of tenants’ implied wishes, their intentions and needs. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,16 and 17. Quality in this outcome area is good. Tenants had access to a wide range of activities and pastimes and were encouraged to take part in them. Opportunities to develop independent living skills were made available and tenants encouraged to develop their abilities, exercise choices and fulfil their ambitions whenever appropriate and possible to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two tenants who would usually have attended a day centre on the day of the inspection were in fact at home. This was because the day centres they used were closed to facilitate staff training. Day centres provided an agreed programme of activities designed to meet tenants’ needs. Other tenants habitually spent more of their time at home and their care plans contained a ‘Day Care Plan’ of activities and pastimes and their timing. Activities incorporated into these plans included independent living skills and food preparation plus other recreational activities. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 13 Tenants were found to have access to a range of activities, including swimming, bowling and sailing. Sailing was made available through the Nancy Oldfield Trust on a specially adapted boat on the Broads. One tenant enjoyed being included on food shopping expeditions. Others took part in tabletop games and arts and crafts. One tenant was observed to spend considerable time through the day drawing. Another tenant was enjoying music in his own room. One member of staff said he and a colleague were musicians and sometimes brought their instruments to the care home to play for the tenants. We (CSCI) asked the manager about transport arrangements for the care home and it was explained that Ashwood House shared a mini bus and car with another of the organisations’ care homes. The reservations about this arrangement voiced by a relative were discussed with the manager and it was agreed that sharing a mini bus and a car did on occasion make it difficult for tenants to be taken out as often as they would like. A Recommendation was made that the adequacy of this arrangement be reviewed, taking the views of tenants in to account. Staff related that tenants from Ashwood House and the other nearby Jeesal care home frequently got together for parties and social events. In addition tenants were enabled to visit local amenities, such as shops, the community hall and pubs. Some tenants made visits to family members on a fairly regular basis or went on outings with their relatives. Over the past year 2 tenants, accompanied by members of staff had gone on holiday in Europe. The manager related that it was not appropriate for all of the tenants to take a holiday together as needs varied greatly. Trips were arranged to suit individual needs and choices. One tenant had twice been enabled to take holidays abroad in Europe and it was hoped that in the near future she would be able to make an even longer trip to Barbados. We (CSCI) noted from tenants’ files and care plans that there had been occasions when relationships between tenants had been less than harmonious. Appropriate action had been taken to resolve past conflicts and all causes for concern were recorded and monitored by the manager. In addition to contributing to the planned content of menus, some tenants liked to help with food preparation. One tenant, (together with a person it was anticipated would be admitted to the care home in the coming week) occupied the upstairs apartment. This had its’ own kitchen and dining area. It was anticipated that with some input from staff these two people would be enabled to produce their meals on a regular basis. Though we (CSCI) did not observe tenants taking a meal together as a group, the consumption of snacks and drinks was observed along with preparations being made for a meal later that evening and it was evident that tenants exercised choices. This concurred with findings from tenant and relatives surveys and the observations of the previous inspection of 2007. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 14 We (CSCI) noted from care plans that 2 tenants were having their food and drink consumption closely monitored as both had experienced recent weight loss. Both were patients of NHS dieticians who had provided clear guidance on treatment. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good as tenants received the personal care and health care support they needed. There were some discrepancies in the way medication was recorded that needed addressing but this did not appear to have affected anyone. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The health care needs of the tenants whose files were examined were generally well documented. The manager had already indicated on those care plans in need of review where particular aspects of health care were to be reassessed. The personal care support needed by tenants had been carefully assessed and guidance set out so that members of staff could encourage tenants to do as much as they were able for themselves while ensuring they received the assistance they needed. One relative commented, “They (the Tenants) are all well fed and clean and we cannot personally find any fault with Ashwood House – they are all willing and helpful.” This view was supported by another relative who said, “We are very satisfied with the care given and never find anything to complain about”. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 16 One tenant with mobility difficulties was provided with a range of aids to movement. The care plan ensured members of staff had appropriate guidance as to the level of support to offer and how to make use of the equipment provided. Another tenant with decreased mobility had taken the opportunity to move to a ground floor room so that independence should be least affected by his condition. Visits to tenants by health care professionals and the outcome of consultations were recorded, as were investigations into injuries, however minor. None of the tenants whose files were examined were assessed as able to manage their own medication. Each tenant had a current medication list contained in their care plan. Members of staff were provided with information about the type of medication being prescribed, its purpose and potential side effects and clear guidance had been set out with rules over the administration of certain PRN (as required) medication. All staff authorised to administer medication had been trained to do so. We (CSCI) found that medication was securely stored in a locked cabinet within a locked cupboard. The majority of daily medication was supplied in monitored dose system. Medication administration records were examined and found to be correctly completed, save in the following instance. We (CSCI) found that some medication listed as a controlled drug was being administered. Although a member of staff informed us (CSCI) that administration of all medication was performed in front of a witness (second member of the staff team) the care home lacked a controlled Drugs Register in which to record this. This contravenes the Misuse of Drugs (Safe Custody) Regulations 1973. (Controlled Drugs must be secured in the wall mounted locked cupboard and a Register kept as to the quantity, administration, witness to administration and disposal of the drug in question). Requirement Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Tenants had the opportunity to raise concerns at the regularly held ‘Tenants’ Meetings’. There were minutes taken of these meetings enabling the manager to keep a check on how issues raised were dealt with. The complaints procedure was available to all and acceptable although tenants might have appreciated a version better designed to suit their abilities. Members of the staff team understood the importance of protecting the vulnerable adults in their care from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care home’s complaints procedure was contained within the Service User Guide and for general use was satisfactory. Tenants would have benefited from this document being produced in a user-friendly format. (See recommendation – Choice of Home Section) Tenants’ meetings granted people living at Ashwood House the opportunity to make their views known and members of the staff team were observably good at noting when ever a tenant appeared distressed or concerned in any way. There had been no complaints made about the service since the previous inspection. All members of the staff team had been CRB checked and, with 2 exceptions were trained to protect vulnerable adults from abuse. The 2 exceptions were the most recent recruits to the team but their places on a training course had already been booked. One new recruit explained how issue of abuse had been addressed during the induction-training programme. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 18 The whistle blowing policy and procedure were contained in the care home’s manual on policies which all staff were compelled to read, and revisit at 6 monthly intervals. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 and 30. Quality in this outcome area is good. Tenants had access to private accommodation and communal areas that were clean and bright and appeared safe as well as comfortable and furnished to a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection of February 2007, Ashwood House had undergone considerable change, having been altered and redecorated throughout. The upper floor of the premises had been converted into a selfcontained apartment, linked to the rest of the house by its’ original staircase but with an additional, new, private access and stairway. The apartment consisted of 2 bedrooms, a bathroom, kitchen dining room and lounge. All of these rooms were tastefully decorated, furnished to a good standard and appeared very comfortable. One room remained as yet unoccupied. The person occupying the other room was unavailable at the time of the inspection but had evidently begun to turn this room into his own personal space. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 20 The apartment had in addition its’ own screened off portion of garden for the private use of its’ 2 tenants. On the ground floor there were 6 bedrooms. One person was happy for us (CSCI) to see their room. This was pleasantly appointed to a similar standard as the rooms upstairs, nicely furnished and had been made more personal by addition of items special to the tenant. Communal accommodation consisted of a through lounge and dining area with an adjacent kitchen. All of these areas had recently been redecorated and were well furnished, attractive and spacious. The conservatory had been adapted to provide a second sitting area with smaller TV and games console, activity equipment and storage as well as comfortable seating. A large garden at the rear of the premises was partially used for recreation but one area had been designated as a future vegetable patch where it was planned tenants and staff could grow their own vegetables in 2008. Within the garden area a cabin had been sited and was currently in use as the manager’s office. The rear grounds were separated from those at the front where adequate car parking was available. All areas of the care home were found to be clean and tidy to a commendably high standard. There were no unpleasant odours anywhere. The grounds also appeared well cared for. Radiators throughout the home were covered. Lighting was domestic in type. There were no observable causes for concern over safety. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. The tenants benefit from receiving support from a motivated, well-trained and supervised staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the course of the inspection the care home appeared to be well staffed. The appointed manager, while not on site all day because she was attending a meeting at another, nearby Jeesal Care home which she also managed was never the less available and able to reach the premises within a matter of minutes from being called. A senior support worker had charge of the care home during the day and the deputy manager arrived to take charge mid afternoon. There were an additional 2 members of staff on duty as well throughout that time. It was understood from the deputy that at night-time there would be one waking member of staff on duty with a member of senior staff sleeping at the other Jeesal care home in the same road who would be ‘ on call’ to both homes. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 22 The files of 3 members of staff were examined and each contained evidence of training, including induction, and regular supervision. Each contained a copy of the General Social Care Council Code of Practice. In the manager’s office, a chart was displayed on the wall showing the training already completed by all members of the staff team, date when any of this training would need to be updated by and training dates already booked. From this it was revealed that team members were appropriately equipped to undertake their roles. The manager confirmed that all members of the staff team had been CRB checked. She described the procedures undertaken when staff were recruited and how they were introduced into the care home, saying that no one was expected to work in the care home till they had completed 6 weeks of shadowing another member of the team, had completed their induction training and shown themselves to be sufficiently confident and competent. Members of staff on duty were spoken with about their roles and responsibilities. All spoke with enthusiasm about their work and said how much they enjoyed being part of the staff team and able to contribute to the care of the tenants. One member of staff said coming to work at Ashwood House was the best career move they had ever made because “working with these guys (the tenants) puts everything in life into perspective. I’ve never done anything that gave me so much satisfaction”. Another member of the team referred to training opportunities and how these were provided to ensure staff felt confident in fulfilling their roles. Members of the team had received training particular to the needs of the tenants, including courses on how to recognise and deal in a non-physical manner with aggressive forms of behaviour. Total Communication Co-ordinators had been trained in specialised communication skills, for example ‘Sing-along’ and the use of Communication Boards. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been formed despite the shortcomings noted in evidence. We (CSCI) acknowledge that the new manager was aware of matters that needed to be attended to but had not yet had sufficient time in which to act on some of these. The manager had a clear overview of how the service should develop so as to ensure tenants best interests were met. The staff team were appropriately trained, supervised and led. The health safety and welfare of tenants was safeguarded by comprehensive risk assessment and the maintenance of the premises. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection of February 2007, the then registered manager of Ashwood House had resigned and a new manager had been appointed. The appointed manager already managed a care home operated by the service providers and she hoped to be registered with CSCI in the near future. She Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 24 was in the process of gaining the managers’ award, NVQ Level 4 in Care Management and was trained and experienced in working with people with Learning Difficulties. It was evident that tenants stood to benefit from her taking charge of the care home as a number of improvements had been made since her appointment including the commenced review of care plans and identification of where new assessments were needed. Members of staff were now being regularly supervised and reporting systems more closely adhered to. There was no evidence that the providers had conducted inspections and produced reports of their findings in line with Regulation 26 since 2006. Requirement At the previous inspection a requirement was made for elements of quality assurance monitoring to be drawn together into a single cohesive report (copy to CSCI). The service provider agreed to provide a copy of the completed document following the inspection visit. Health and safety had been well monitored within the care home. Risk assessments had been produced for all areas of the premises and these were checked on each month. Fire safety was included in the risk assessments. Staff had completed full fire drills in 2006 and 2007. Fire fighting equipment, alarms, emergency lighting had all been subject to maintenance checks and certified correct in January 2008. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 26 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 YA20 Regulation 13 (2) Requirement Timescale for action 01/03/08 2 YA39 26 (2) Medication identified as a controlled drug must be stored in a wall mounted cabinet and a controlled drugs register provided in which to records the quantity of the drug in stock, its’ administration, the witness to its’ administration and disposal or return of that drug to the issuing pharmacy. The registered provider must 31/03/08 conduct monthly inspection visits to the care home, produce a report on findings and submit a copy of this report to the manager and to CSCI 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. Refer to Standard YA5 Good Practice Recommendations Contracts entered into between the tenants and the care home should be signed to indicate that all participants agree with the content. DS0000027521.V359091.R01.S.doc Version 5.2 Page 27 Ashwood House 2. 3. YA6 YA14 The manager should complete the review of tenants care plans by 01/05/08 A recommendation was made that the adequacy of the home’s transport arrangements be reviewed, taking the views of tenants in to account. Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashwood House DS0000027521.V359091.R01.S.doc Version 5.2 Page 29 - 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. 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