Inspection on 25/07/07 for Askham Place

This inspection was carried out on 25th July 2007.

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

Other inspections for this house

Askham Place 23/07/08

Askham Place 18/05/06

Askham Place 20/12/05

Askham Place 03/05/05

Askham Place 01/02/05

Askham Place 25/05/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Askham Place Benwick Road Doddington Cambridgeshire PE15 0TG Lead Inspector Alan Buttery Unannounced Inspection 25th July 2007 10:00 Askham Place DS0000024299.V348361.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 Askham Place DS0000024299.V348361.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. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Askham Place Address Benwick Road Doddington Cambridgeshire PE15 0TG 01354 740269 01354 741996 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) www.askhamcarehomes.com Askham Care Homes Limited ***Post Vacant*** Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th May 2006 Brief Description of the Service: Askham Place is a purpose built single storey home providing nursing and personal care for up to 15 service users aged between 18 and 65 with a physical disability. The home was first registered in September 2001, and is close to the small Cambridgeshire village of Doddington near March. The home is in the grounds of Askham House, a service for older people under the same ownership as Askham Place and shares kitchen and laundry facilities. Since the last inspection, a new manager has been appointed, and will be applying for registration with the CSCI in the near future. The home provides for up to 15 people under the age of 65 with a physical disability, and is currently full. Fees charged range between £900.00 and £1200.00 per week, depending on the assessed needs of the individuals. Copies of the most recent inspection reports are available on request from the administration office in the home, and in the reception area. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, and followed a random inspection made in April of this year, during which a number of serious issues were identified, and which were looked at again as part of this inspection. The manager of the service has yet to complete her registration with the commission, but the application process is underway. The service does not currently have any vacancies, with two new admissions in the last six months, and a full complement of staff, based on current staffing levels. Information contained in this report from discussions with the manager and staff, and from the Annual Quality Assurance Assessment submitted by the provider, as well as observations made by the inspector during the visit. What the service does well: What has improved since the last inspection? Since the last inspection, a number of the requirements made have been met, and the new manager and head of care are instigating a number of changes. The level and variety of activities available to people living at Askham Place has improved considerably, with a very committed activity co-ordinator accessing a number of new activities, supported by the staff team in the home. A new group ‘Friends of Askham Place’ has been established to help organise fund and run activities and events, and the views of people living in the home are now helping to formulate new ideas. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Askham Place DS0000024299.V348361.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 Askham Place DS0000024299.V348361.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): Standards 2 and 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Detailed information is available to people wishing to move to the service and full assessments take place to ensure identified needs can be met by the service. EVIDENCE: Prior to any new admission to the home, a detailed assessment is undertaken by the manager to ensure that they are able to meet the identified needs of anyone looking to move there. The people living in the home are all funded by their local authority, and the process therefore begins with a referral to the service by their care manager/social worker. A visit is arrange to meet with the possible new admission, and often their family, which is undertaken by the manager and/or head of care and usually at the home of the person seeking to move to Askham Place, although it can sometimes be whilst the individual is still in hospital. During this visit the detailed assessment of need is carried out, and the prospective admission given details of the service offered. The assessment information is added to the local authority information, which would accompany the referral, and from this the service is able to confirm whether they are able to meet the individual need. A visit is arranged wherever Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 9 possible to enable the individual to see the service before deciding whether they wish to move there, but this is not always possible. One recent admission spent two weeks at Askham Place on respite pending a decision to move permanently to the service. Evidence was seen on the files examined for three people currently living in the home that this process is being followed, and the necessary assessment information obtained. Askham Place DS0000024299.V348361.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): Standards 6, 7 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Individual plans detail support required, but more evidence of the involvement of the people they affect is required. EVIDENCE: Since the random visit in April 2007, a new format has been introduced for care plans, which are now split into two, a nursing plan and a more general person centred plan. It was felt that this split system may be confusing to staff as the main plan is completed by one of the qualified staff, the secondary plan by a key worker, and the service should consider whether this is the most efficient manner of individual planning, and whether the focus on outcomes for people in the home is sufficient. At the present time, not all the care plans have been rewritten, and this will be considered further at a future inspection. However, the existing plans do not demonstrate sufficiently how the individuals living in the home have contributed to their plan, which must be addressed. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 11 The Person centred aspect of care planning being introduced should ensure that individuals are more able to make decisions about their day to day lives, and this needs to be recorded within the plan. Risk assessments are carried out as part of the initial assessment process, which were seen on the individual files examined, covering both individual and generic risks, and these are used to support individuals in day to day living. Askham Place DS0000024299.V348361.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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. A wide range of activities and events are provided, often including families, in line with people’s wishes and interests. EVIDENCE: Since the random inspection visit, the service has employed a new activities co-ordinator, who has already made a big difference to the lives of people living in the home. There are far more activities available, and more planned, and greater involvement in the local community. For example people living in the home have helped make a scarecrow entered into a local competition, and have held a Barbeque for friends and families. It is also notable that staff are volunteering to be part of this, often in their own time and unpaid. Further planned events include a September ball as well as trips out and about, for example a trip is planned to Hunstanton, and to local events and facilities including a local show, bowling and the local Pub. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 13 In house activities include ball games (which were taking place on the day of the inspection), bingo, sports afternoons and a fashion show, and events are advertised on a large notice board. To ensure that events are arranged suited to the individuals living in the home, the activities co-ordinator has spent time with each individual, talking to them and finding out what they like doing and what interest they have, and arranging events accordingly. This social background should be incorporated in the individual care plans. Families are welcome, and as the inspection finished, a tea and cakes afternoon had started involving the people living in the home, their families and staff, which was very well attended. A new menu has been introduced, and the people in the home have a choice of main meal, often three options available. Support in nutrition is obtained from local health professionals. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Healthcare needs are identified and met appropriately, and people living in the home receive their required medication. EVIDENCE: The service offers nursing support to the people living there with a range of complex needs, and always have qualified nursing staff working, as well as care staff. As mentioned earlier, the care plans are very medicalised, detailing the health needs of the people in the home, and ensuring their health needs are met. A new head of care has recently been appointed, and is looking at many of the systems in place, with a view to making improvements, for example in medication procedures. The home has an appropriate medication policy, and currently medication is dispensed by the local surgery. They are currently looking at the Boots Monitored dosage system, which may be easier to administrate. The manager has met with the Practice manager at the local surgery, and reported that they have a good working relationship. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure concerns or allegations are suitably dealt with and the people living in the home not at risk. EVIDENCE: Since the Random Inspection, no complaints have been received. A new system of logging complaints and concerns has been introduced, and the services policy and procedure in managing complaints is being followed. A Policy for managing allegations of abuse is also in place, and two incidents earlier in the year were dealt with appropriately. All staff receive training in Adult protection matters as part of their induction, and regular updates. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 16 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): Standards 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A comfortable and clean environment is provided fro the people living in the home. EVIDENCE: Askham Place continues to offer a spacious and well equipped home for the people living there, with a good range of facilities including overhead tracking in all rooms, lounge and dining areas, and attractive gardens, and each individual room has its own door leading to the garden. The home was well presented, and cleans on the day of the visit, with no offensive odours. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 17 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): Standards 32, 34 and 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff working in the service have clearly defined roles, each shift has qualified staff, care staff and domestic staff available, depending on the time of day, and the service is fully staffed at present. A number of issues were identified relating to recruitment procedures at the random inspection visit earlier in the year, and although some of these have been addressed, the staff files examined still showed issues of concern. For example, gaps in employment are not being properly explored, one file examined clearly showed gaps in the employment history of a recent applicant, but the interview record did not follow this up in any way. Another application indicated a serious conviction, but no discussion or explanation was recorded on the interview notes, and when questioned, the manager could not recall any details, and appeared top confuse this applicant with another. Other records showed that not all references are being verified, and the service are not always seeking a reference from the last named employer. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 18 Staff are now receiving better induction training and a range of training has taken place or is planned in the coming months, including moving and handling, POVA, food hygiene and more specific training to meet identified need. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. EVIDENCE: As mentioned earlier in the report the new manager is completing her application for registration, and has made a number of improvements since the random visit. However, further identified issues relating to recruitment must be addressed, which will be considered at the next key inspection. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 20 Regular management meetings are held, and a new head of Care appointed, and further changes and improvements are being implemented. One area of concern was a reported lack of access to information and facilities outside office hours and at weekends. The inspector was told that the staff have no access to provide people living in the home with money if they wish to go out on an unplanned trip during the evening or at weekends, and that if an emergency hospital admission was needed the staff have no access to a photocopier to provide copies of medication records etc to the Paramedics. Since the inspection, the provider has confirmed that arrangements are in place with the residential home next door, owned by the the provider which has access to an emergency cash float and to printing and photocopying facilites. Further Person Centered work is in progress which will better evidence how individual wishes are reflected in the service delivered. A range of health and safety training together with the relevant policies and procedures is available, ensuring that people living and working in the home are not placed at risk, and records of maintenance were seen during the visit. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 3 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 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 2 3 X X 3 X Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 22 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 YA6 Regulation 15(1) Requirement Individual plans must demonstrate the involvement of the individual receiving care Carried forward from previous inspection The registered provider must be satisfied as to the authenticity of references obtained to ensure the safety of people in the home Carried forward from previous inspection Documents and requirements specified in schedule 2 of the regulations must be obtained prior to any new employee joining the service to ensure the safety of people in the home Carried forward from previous inspection. Timescale for action 30/09/07 2. YA34 19(1)(c) 30/09/07 3. YA34 19(1)(b) 30/09/07 4 YA37 9(2) The application for the 30/09/07 registration of the manager must be submitted as soon as possible in order that her fitness to be registered can be assessed. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 23 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 YA38 Good Practice Recommendations Management arrangements should enable senior staff to access equipment and resources needed at all times. Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office 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 Askham Place DS0000024299.V348361.R01.S.doc Version 5.2 Page 25 - 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. 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