Inspection on 01/07/05 for Aspen House

This inspection was carried out on 1st July 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 but made no statutory requirements on the home.

Other inspections for this house

Aspen House 29/06/07

Aspen House 10/05/06

Aspen House 14/12/05

Aspen House 03/02/05

Aspen House 24/09/04

Aspen House 30/07/02

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

CARE HOMES FOR OLDER PEOPLE Aspen House 17 Wilbury Avenue Hove East Sussex BN3 6HS Lead Inspector Merle Blakeley Unannounced 1 July 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aspen House Address 17 Wilbury Avenue Hove East Sussex BN3 6HS 01273 772255 01273 772255 None Mrs Denise Marie Bernadette Roussel Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Denise Marie Bernadette Roussel Care Home 15 Category(ies) of Dementia (DE), 15. registration, with number of places Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of people accommodated must not exceed 15 2. The people accommodated will be aged 65 years or over on admission 3. The people accommodated will have a senile dementia type illness Date of last inspection 3 March 2005 Brief Description of the Service: Aspen House is registered to provide care and accommodation for up to fifteen older people who are in the various stages of dementia. The property consists of a large detached house with an additional two-storey purpose built extension. Residents bedrooms are located over two floors and there are nine single rooms and three shared rooms. Six of the bedrooms provide en suite facilities. A stair lift is available. Communal facilities include a lounge, a small quiet room, dining room, large entrance hall and a patio garden. The home is located in a quiet residential area of Hove, which is reasonably close to local transport and other amenities. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over a period of three and a half hours on July 1st 2005. The inspection process included speaking with several residents, relatives and staff, discussions with the proprietor/manager, tour of the premises and document reading. What the service does well: What has improved since the last inspection? What they could do better: There are several requirements, which the home needs to address. The requirement for an assessment of the home by an occupational therapist has now been made twice and the proprietor must now comply with this regulation. Care plans need to be updated on a regular basis and particularly when a change in a resident’s assessed needs has occurred. The home has been wedging open certain internal fire doors and it is vital that the home provide these doors with automatic self-closers to protect residents and staff in the case of a fire within the home. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 6 The proprietor/manager has stated that these closers are due to be fitted in the next few weeks. Regular supervision sessions for staff must commence as soon as possible; as to date only one staff member has received a supervision session. Resident Satisfaction Surveys also need to be carried out at least twice a year to gauge how well the home is operating and meeting needs. 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. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4 & 5 The home provides each resident with terms and conditions. The home tries to ensure that it meets resident’s needs. Residents and their relatives can make visits to the home prior to moving in. EVIDENCE: Terms and conditions are provided for each resident and will include the room number that the person is to occupy. The home tries to ensure it can meet resident’s needs by providing a stimulating environment where they can, where possible participate in personal interests and hobbies. Visiting relatives who were spoken to on the day stated that they felt the home was meeting the needs of the residents. All residents are in varying stages of dementia and therefore their needs can vary greatly. Prospective residents and their family are able to visit the home to see if it will meet their needs. Day visits are offered as well as a six-week trial period. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 Not all care plans were seen to be up to date. Medication records were checked during the inspection. EVIDENCE: The proprietor/manager is responsible for maintaining care plans for residents. Though generally well maintained some care plans did not have up to date information and reviews written up. It is important that any changes to residents assessed needs are documented as soon as possible. Some of the care plans also appeared confusing in the way they are set out and this was discussed with the proprietor/manager. In the future the home is to introduce a key worker system whereby staff will be responsible for completing and maintaining specific care plans. None of the residents self medicate. Medication records were viewed and appeared to be suitably maintained. Some recommendations were made during the last inspection and one of these was to provide a more secure storage cupboard for the medicines. The proprietor stated that she is still looking into this. Other recommendations that were made have been completed. Medication training for staff is being organised. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Residents are offered an activities programme. Visitors are made welcome in the home. The home provides a balanced diet and resident’s preferences have been taken into account. EVIDENCE: During the inspection several residents were involved with a painting activity in the dining room. An activities co-ordinator is employed to come into the home once a week to provide stimulating arts & crafts and music sessions for residents. Some of the residents were very engrossed in the activity and said that they enjoyed these sessions. Weekly piano sing-a-longs and exercise classes are also held. A religious minister also visits the home on a monthly basis to hold a service. Visitors are welcome in the home day and night and several relatives were seen during the day. They stated that the home is welcoming and that they can visit at most times of the day. The home operates a six-weekly menu and the proprietor stated that they are introducing some slight changes to the menu. Some residents have requested that more salads be introduced to the menu. The home has also asked visitors about food options their relatives might like. The service records the meals that are cooked and eaten. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 CRB checks are now undertaken on all new staff members prior to commencing work at the home. EVIDENCE: During the last inspection it was found that the home was employing staff to work before they had received a CRB clearance check. Recruitment files were checked during this inspection and all current staff were found to have a returned CRB check. All the staff team have now attended training in Adult Protection. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21, 22 & 26 The home has yet to comply with fire safety regulations and fit self-closures to some internal doors. An assessment of the home by a qualified occupational therapist still remains an outstanding requirement. The home was found to be clean and tidy with no obvious offensive odours. EVIDENCE: During the last inspection some internal fire doors were being propped open with door wedges, which is a fire hazard. A Fire Safety Officer visited the home and informed them that they must provide suitable self-closer fittings to these doors, which would close automatically in the event of a fire. The home has yet to comply with this requirement. The proprietor/manager stated that the self-closers are due to be fitted onto doors in the next few weeks. A requirement was also made for the home to undergo an assessment by a qualified occupational therapist to ascertain as to whether any adaptations are necessary for the residents who live there. This requirement has been made twice and has yet to be met by the home. Overall the home is clean and tidy and free from offensive odours. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 & 30 Some of the staff team have obtained an NVQ qualification. Recruitment practices for the home have improved. A good level of staff training has been achieved this year. EVIDENCE: To date three staff have obtained their NVQ Level 2 qualification and another staff member is due to complete this level soon. One other staff member has completed NVQ Level 3 and two others are due to commence Level 2 later this year. The home now has a reasonably stable staff team and there is one vacancy at present. During the inspection staff were seen to interact with residents in a positive and friendly manner. Recruitment practices have improved with the proprietor/manager stating that new employees will not start work without a returned CRB clearance check. All other recruitment information is maintained in files. The home has worked well in the past few months to provide a good level of staff training. Training that staff have attended includes Adult Protection Training, Infection Control, Food Hygiene, Fire Training, Dementia, Emergency First Aid and Manual Handling. Medication Training has been booked for several of the staff to attend. Four staff members have also attended the ‘working in care induction standards’ training, which is TOPSS accredited. Staff are provided with an induction and training booklet and this includes the homes procedures and all training that has been completed. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 & 36 The proprietor/manager is completing the Registered Managers Award. More frequent residents satisfaction surveys need to be carried out. Resident’s finances are securely maintained. Staff are still not receiving any regular supervision sessions. EVIDENCE: The proprietor/manager has many years experience of working with older people who have dementia, she is also due to complete the Registered Managers Award by the end of this year. The proprietor/manager stated that she has found it difficult to maintain a lot of the records and administration within the home and will now be delegating some of this work to staff in the future. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 15 The homes quality assurance programme must include seeking the views and comments from residents and relatives on a twice-yearly basis. The home needs to carry out a survey very soon. A suggestion box for residents should also be provided. Resident’s finances were checked and were found to be in order. During the last inspection a requirement was made for the home to provide regular supervision sessions for all staff; this has yet to be carried out. Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 3 2 x x x 3 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x 2 x 3 1 x 2 Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 17 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 OP22 Regulation 13(4) Requirement That the home is assessed by a qualified occupational therapist.This is the second time this Requirement has been made and not met. That suitable screening is provided in shared rooms. Outstanding Requirement from previous inspection. That the home provides self closer fittings for certain internal fire doors. That residents care plans are kept up to date with relevant information regarding their health & welfare. That the home carries out a residents satisfaction survey at least twice a year. That all staff receive a minimum of six supervision sessions per year. Timescale for action 30/9/05 2. OP10 16(2) 30/9/05 3. 4. OP19 OP7 23(4) 15(2)(b) Immediate Immediate 5. 6. OP33 OP36 24(1)(a) 18(2) Immediate Immediate Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 18 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 Good Practice Recommendations Aspen House H59-H10 S14175 Aspen House V230759 010705 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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