Inspection on 26/11/05 for Ashwood Place

This inspection was carried out on 26th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood Place 03/01/07

Ashwood Place 05/10/04

Ashwood Place 06/04/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Ashwood Place Off Sunnyside Road Hitchin Hertfordshire SG4 9JG Lead Inspector Alison Jessop Unannounced Inspection 26th November 2005 10:00 Ashwood Place DS0000019274.V266389.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 Place DS0000019274.V266389.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 Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashwood Place Address Off Sunnyside Road Hitchin Hertfordshire SG4 9JG 01462 435135 01462 435235 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) Caretech Community Service Limited Amanda Dean Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (8) of places Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th April 2005 Brief Description of the Service: Ashwood Place is a small residential care home providig accomodation to people who have a learning disability some of whom may be aged over 65 and/or have an associated physical disability. The home is owned by care Tech Community Services. This purpose built bungalow is designed and equipped to meet the needs of sevice users who have profound learning and physical disabilities. The home has eight bedrooms and large communal areas including a snoozelem room and small courtyard garden. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection in the inspection year and was carried out by one regulatory inspector. The inspection took place on a Saturday afternoon on which all service users were at home. The atmosphere in the home was relaxed on arrival, service users were observed enjoying their lunch. As service users were unable to offer feedback verbally, their response to questions was positive and all service users appeared to be happy. Time was spent in the office scrutinising records and talking to staff. What the service does well: What has improved since the last inspection? Risk assessments have been reviewed and contain comprehensive information. Service user care plans and risk assessments have been updated following a review. The medication room has a thermometer on the wall, which is used to ensure that temperatures are within recommended levels. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashwood Place DS0000019274.V266389.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 Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 The Statement of Purpose and Service User Guide is available to service users prior to moving in to the home. These documents do not provide up to date information and need to be reviewed to ensure that prospective service users can judge whether the home will be suitable. EVIDENCE: The Service User Guide and Statement of Purpose has not been updated as requested at the last inspection. These documents do not reflect the Commission for Social Care Inspection. The complaints procedure also requires review (refer to Standard 22). A comprehensive assessment is undertaken by the manager and her deputy with prospective service users to ensure that the person needs and aspirations can be met. Ashwood Place DS0000019274.V266389.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): 7&9 Service users have high dependency levels and although most are unable to communicate verbally, they are able to express their feelings. Service users are encouraged to express their feelings in the best way they can, this may sometimes be by touch. Risk assessments protect staff from behaviour, which can be expressed if the service user is unhappy for example grabbing, pulling etc. EVIDENCE: One service user was shouting very loudly during dinner and staff recognised this as a sign that he was unhappy. One carer said ‘he may be telling us to be quiet, he sometimes doesn’t like to hear voices whilst he is eating his meal.’ After dinner the service user was taken to his bedroom so that he could enjoy some quiet time. Service user Care Plans are comprehensive and have been reviewed regularly. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Lunch looked very appetising and service users appeared to be enjoying their meal. A balanced diet ensures that good health is promoted, particularly in the winter months. EVIDENCE: The menu is planned each week, which offers a well-balanced and varied diet. Some of the service users require thickener in their drinks as they have swallowing difficulties. Guidelines are available for staff in the kitchen for each service user. Service users preferences are gained by observation of meals they have enjoyed. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 11 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, 20, One service user whose frailty has increased and requires a high level of care looked comfortable and well cared for. The staff team are dedicated to caring for this lady in the home for as long as possible but have realistic views on limitations. EVIDENCE: One service user who has increased frailty requires a high level of care. She has a diagnosed dementia and is physically frail. The manager and staff have sought advice from various specialist resources. The home is currently doing an excellent job in caring for this lady and would like to continue to do so for as long as possible. The service user looked very comfortable in her specialist beanbag chair. Advice had been sought from the district nurse in relation to pressure care and a pressure-relieving mattress has been implemented. Staff monitor food and fluid intake and weight. A review was held where an action plan was agreed between a multi disciplinary team. It was advised that a variation of category is made in order to continue to meet the requirements of registration. Procedures in relation to the administration, storage and recording were satisfactory. The room that the medication cabinet is sited now has a thermometer in order to be able to monitor room temperatures and maintain recommended levels. Temperatures were not however being recorded and Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 12 although were observed at safe levels this may require recording during summer months. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The complaints procedure does not offer the contact details of CSCI, this means that service users and their representatives could be unaware of who to take their unresolved complaints to, should this not be resolved by the home or organisation. EVIDENCE: The Complaints Procedure requires updating as its current format is a generic procedure for all CareTech homes and does not reflect the contact details of the local CSCI office. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. See report dated 29 April 2005 for details of Standards 24-30. EVIDENCE: Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 34 Extra care and support is required for one service user whose dependency has increased. This will ensure that time spent with other service users remains the same. EVIDENCE: Although staffing levels are usually adequate, staff stated that they spend a lot more time caring for one particular service user whose health has deteriorated. It was recommended that extra funding is sourced in order to be able to continue to meet this service users needs and the needs of the other service users. A recommendation was made in the inspection report dated 29th April 2005 for the staff reference form to be reviewed. Outcomes were unavailable as the manager of the home was not on duty. This will be carried forward in the inspection report. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. See report dated 29 April 2005 for details of Standards 37-43. EVIDENCE: Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X X Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 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 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood Place Score 2 X 2 x Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000019274.V266389.R01.S.doc Version 5.0 Page 18 YES 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 YA1 Regulation 6(a)&(b) Requirement Timescale for action 31/12/05 2 YA22 3 YA33 The registered person must update the Statement of Purpose and Service User Guide to reflect CSCI. A copy must be submitted to the commission. Carried forward from the last inspection report. 22(4),(6)&(7) The Complaints Procedure 31/12/05 must be reviewed and must contain details of CSCI. A copy must be submitted to the Commission. Carried forward from the last inspection report. 12(1)(b) The registered person must 31/01/05 make provision for staffing levels to meet changing service users needs. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 19 1 YA20 2 YA34 It is recommended that during the warm weather, the temperature of the medication room is monitored and recorded to ensure that medicines are stored within recommended levels. The company’s reference form should be reviewed to ensure that information gained can be cross-referenced with application forms. Carried forward from last inspection report. Ashwood Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Place DS0000019274.V266389.R01.S.doc Version 5.0 Page 21 - 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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