Inspection on 03/01/07 for Ashwood Place

This inspection was carried out on 3rd January 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood Place 26/11/05

Ashwood Place 05/10/04

Ashwood Place 06/04/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

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 Mrs Judith Kent Unannounced Inspection 3rd January 2007 10:40 Ashwood Place DS0000019274.V325706.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 Place DS0000019274.V325706.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 Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Place Address Off Sunnyside Road Hitchin Hertfordshire SG4 9JG 01462 435135 01462 435235 mandidean@lycos.co.uk www.caretech-uk.com Caretech Community Service 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) 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.V325706.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th November 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.V325706.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the middle of the day when four of the eight service users were at home. The inspector looked around the house and talked with some staff members and the manager. Health and safety records, care plans and medication procedures were looked at. Although service users were not able to respond verbally, those met during the inspection appeared to be content and in one case reacted positively to the inspector. Fees at the home are currently £257 pw. What the service does well: What has improved since the last inspection? What they could do better: The manager is recommended to clarify the Hertfordshire Adult Protection procedure with staff, and to make sure that staff induction assessments are completed. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 6 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 Place DS0000019274.V325706.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 Place DS0000019274.V325706.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence. Service users, their families and supporters can be confident that the home can meet their needs. EVIDENCE: There have been no new admissions to the home since well before the last inspection. Previous reports have shown that full assessments are completed by the manager to make sure that the home can meet the needs and aspirations of the prospective service user. The requirement in the last report that the Statement of Purpose and Service Users’ Guide be updated has been met. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect service users’ individual needs and give clear guidance about their care. EVIDENCE: Service users’ individual care plans are comprehensive; they set out detailed social and health care needs, risk assessments and personal objectives which are identified by staff during their reviews and ‘talk time’ sessions. These sessions are on a one-to-one basis with each person and take place monthly, and although the service users generally communicate non-verbally staff are skilled at interpreting each person’s responses. Successful communication is vital since service users rely heavily on the staff to help them to maintain their quality of life. Care plans and risk assessments are reviewed twice each year – one in-house and one to which all interested parties are invited, including relatives and supporters, care managers and health professionals. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are helped to participate in activities of their choice and to make use of local leisure facilities. They are offered a nutritious and balanced diet. EVIDENCE: Each person has a regularly updated weekly programme which includes a range of activities. Four of the eight service users living at the home attend day centre on five days each week, helping to maintain and develop links outside the home and to enable them to take part in a variety of activities and projects. On the day of the inspection the programmes for those remaining at included a cooking session with the staff, although this did not appear to have taken place on this particular day. In-house entertainment includes karaoke (popular!), music and art sessions. The home has the use of a van to take service users out shopping and to places of interest such as theatre, farms and museums, and holidays are arranged for those people who choose to go. The home offers service users a nutritious, healthy diet and uses fresh vegetables and fruit. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are helped to use the full range of healthcare facilities available to them; medication in the home is managed well. EVIDENCE: Service users’ records show that their health care needs are met and that they are helped to access health care professionals and complementary services by the staff team. There is clear advice and guidance in care plans about how to maintain service users’ wellbeing. None of the service users manage their own medicines and records, storage, and administration of medication is satisfactory. The manager audits medication regularly and a pharmacist from Boots chemist, who supply the home, also carries out a six-monthly audit and advisory session for the staff group, who have all received training in administering medication. A requirement in the last report that a check is kept on the storage temperature of medication has been met - the records show that it is within acceptable limits. The home cares for several physically dependent people and observation of care practice showed that staff communicate well with them, reassuring and explaining what is happening. There has been considerable consultation with about the care of one person in particular and the manager has recently Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 12 obtained agreement from the commissioning service to provide extra support for her, so that she can continue to be cared for in the home. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected from harm by the home’s policies and procedures and can be confident that any complaints about the home will be listened to and investigated. EVIDENCE: The home’s complaints procedure has been amended to include CSCI information (although this has yet to be updated to reflect the current contact details) and is made available to service users in a user-friendly format. Staff in the home have received training in adult protection and abuse recognition and understand the significance of the home’s whistle blowing procedure. There is a copy of the Hertfordshire Adult Protection manual in the home and it is recommended that the staff team have a refresher session to ensure that everyone is familiar with the procedure to follow. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe place for people to live and is wellmaintained and very clean. EVIDENCE: The communal areas in the home have a comfortable and homely atmosphere and are decorated to provide stimulation for service users. During this visit the Christmas decorations were still up giving a festive air to the home. The conservatory is currently being redesigned and adapted to provide a fully equipped sensory room. Each bedroom has an individual theme and colour scheme according to the preferences of the occupant, and many have stimulating accessories on the walls and ceiling. The home was odour-free and very clean and is well-maintained throughout. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are cared for by a stable and well-trained staff group; staff members have had the necessary security checks to ensure that service users are protected form harm. EVIDENCE: The current staff to service user ratio is1/2, although the increased frailty of one service user has resulted in high demands on staff time. The recent successful application by the manager to the commissioning service for additional care for the person during the morning will mean that the staff will be able to spend more time with the other service users. The home benefits from a stable and long-serving staff team and there has been only one new member since the last inspection. Examination of his recruitment file showed that all the necessary checks had been completed, although Criminal Records Bureau (CRB) disclosures are now held by agreement with the CSCI at the company’s head office and are not available for inspection. The new staff member confirmed that he had had an induction and that he had begun mandatory training, although his induction record had not been signed off by the manager. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 16 Records show that mandatory and other training takes place and that there is a commitment to helping staff to gain National Vocational Qualifications (NVQ). There is a full staff meeting each month as well as a meeting for the senior staff, and individual supervision takes place regularly. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 17 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, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The quality of the service provided is monitored regularly and service users and other stakeholders are consulted about how the home is run. Service users’ safety is protected by the home’s procedures. EVIDENCE: The registered manager of the home holds the NVQ Level 4 management qualification and is soon to complete the Registered Managers Award; the deputy manager is completing NVQ Level 4 and all the senior staff hold the Level 3 award. There is a robust quality assurance system operating in the home; apart from monthly meetings and the individual the talk time that staff spend with service users, there are fully documented monthly audits by a senior manager of the company and a twice yearly audit by an independent auditor. Every aspect of Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 18 the home is looked at during these audits and service users, family members and care managers are asked to comment on the quality of the service provided by the home. The audit documents were available at the inspection and show that the home has an excellent record in meeting both National Minimum Standards and Caretech requirements. Outcomes of audits are notified to the manager and she confirmed that action has been taken to rectify identified shortfalls. Records in relation to health and safety in the home are maintained and show in particular that fire safety procedures are tested regularly. The home holds some cash for service users - two were checked at the inspection and found to be correct. The records are subject to monthly checks and to the twice yearly audit. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 19 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 x 2 3 3 x 4 x 5 x 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 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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 YA35 Regulation Requirement Timescale for action 03/01/07 19(1)(b)(i) The registered manager must & ensure that records of staff Schedule training are completed. 2 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 YA23 Good Practice Recommendations It is recommended that a refresher session on the Hertfordshire Adult Protection procedure is held to ensure that all staff are aware of their responsibilities. Ashwood Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Place DS0000019274.V325706.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!