Inspection on 10/05/06 for Aspen House

This inspection was carried out on 10th May 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Aspen House 29/06/07

Aspen House 14/12/05

Aspen House 01/07/05

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 Key Unannounced Inspection 10th May 2006 10:00 X10015.doc Version 1.40 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 Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 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 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 DS0000014175.V289636.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aspen House Address 17 Wilbury Avenue Hove East Sussex BN3 6HS 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) 01273 772255 01273 772255 Mrs Denise Marie Bernadette Roussel Mrs Denise Marie Bernadette Roussel Care Home 15 Category(ies) of Dementia (15) registration, with number of places Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fifteen (15) Service users must be aged 65 years or over on admission Service users accommodated will have senile dementia type illness Date of last inspection 14th December 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. Resident’s 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. The current scale of fees is from £409.00 to £441.00. Chiropody and hairdressing are extra charges. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Key Inspection was carried out over a period of seven hours on 10th May 2006. The inspection process included speaking with some of the residents, talking to relatives and visitors, feedback from a visiting professional, observations of the interactions between staff and residents, looking at the needs of four particular residents, document reading, tour of the premises and informal discussions with the owner/manager and the staff on duty. Information was also gained from a completed pre-inspection questionnaire and satisfaction survey forms received from a number of relatives. What the service does well: What has improved since the last inspection? What they could do better: Although care plans and reviews are up to date they do need to contain a more in-depth history, which should include information about residents past employment, hobbies and pastimes. This information should be used to provide more personalised activities for residents, as some have said that they Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 6 would like more to do during the day. During this inspection it was observed that residents spent most of their time in the lounge watching television. The home needs to look at increasing the level of activities for some of the residents. Overall residents stated that they enjoyed the meals, however it was noted that not a lot of fresh vegetables and other produce was being included into the daily diet, as it was mainly all frozen. The home also needs to follow the guidelines for blending meals for residents. Each food item should be liquidised separately to retain is original colour, smell and flavour e.g. the meat, potatoes and vegetables are blended separately and not all in together. Some parts of the home need redecorating and reorganising. The lounge room is cluttered and full of items of furniture that are not always used consequently residents cannot even see out of the windows. It is important that this room is revamped and made more comfortable, as residents spend a lot of their time in this room. Some of the armchairs are worn and need replacing. The dining room also needs redecorating and lighter drapes in the window, as again residents cannot see out of these windows. The radiator cover in the ground floor toilet needs to be more securely attached to the wall and fire drills need to be carried out more often. An action plan addressing the requirements made in this report was received prior to publication. 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 DS0000014175.V289636.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 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 the following standard(s): 3. Standard 6 is not applicable to the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner/manager carries out assessments on all prospective residents. EVIDENCE: Normally prospective residents are referred to the home via hospitals and community mental health teams. Reports, histories and current assessments are normally carried out by these agencies before a resident moves into the home, so the owner/manager has prior knowledge of a persons needs. The owner/manager will also carry out an assessment to ascertain as to whether the home can meet their needs. The homes assessment covers the areas of physical health, mental health and personal information. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are reviewed on a monthly basis. Care plans need to contain more in-depth histories on residents. Resident’s health care needs are met and medication is being appropriately administered. Observation of staff indicated that residents were being treated with respect. The home has recorded the wishes of some residents regarding illness and death. EVIDENCE: Several residents care plans were viewed and they appeared informative and up-to-date, however they need to include more information about residents life histories such as past hobbies, habits, interests, family life etc. This additional information can assist staff in exploring other optional pastimes or activities that may interest residents. The health care needs of residents appear well catered for. Residents have access to psychiatrists, CPN’s and district nurses when required. The home also maintains good links with local professional health care teams. One particular resident is now quite unwell and the district nurses are in attendance and they will assess as to whether this resident now requires nursing care. The district Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 10 nursing staff team has provided an air mattress and a hoist. Another resident is having his medication monitored as his behaviour has changed quite rapidly. MIND advocates also have contact with the home. Medication records were checked and they were found to be in order. During this visit staff were observed interacting with residents and they appeared to be treating residents with respect and dignity. Two staff were observed using a hoist to change a resident who has become bedfast. The curtains were closed beforehand to preserve dignity and privacy during this procedure. A requirement was made during the last inspection for the home to address the personal wishes of residents regarding illness and dying. The owner/manager stated that some resident’s wishes have now been recorded, however several residents refused to discuss this topic and therefore their wishes could not be recorded. The home also receives information from family members and friends as to the known wishes of their relatives. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to provide some residents with a more varied range of activities. Residents maintain contact with their relatives and friends. Not all residents have the capacity to exercise choice and control over their lives. The home needs to follow current guidelines when providing blended meals for residents. EVIDENCE: During the week some regular activities are held, which include exercise to music classes once a week, a musical entertainer one afternoon a week and an arts and craft class every Friday morning. Some residents appear to enjoy these sessions. Some said that they would like more things to do during the day. The home needs to look at providing a broader range of specific activities for some of the residents, particularly those who retain interests in certain hobbies and pastimes. Visitors are very welcome in the home and on the day several relatives and friends were visiting. The inspector was able to talk to visitors about their views on the care their relatives receive at Aspen House. The responses were very positive and visitors felt the residents were receiving a good level of care. It was also stated that the staff were friendly and helpful. As the weather was Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 12 pleasant some residents were able to sit out in the garden with friends and relatives. Most of the residents now lack the capacity to exercise choice and control over their lives, however where possible residents can make decisions about certain aspects of there daily lives. Relatives and friends are able to assist residents where possible and for those residents who do not have family or friends access to advocates is available. Two residents currently have advocates. Meals are cooked by one of the staff team and overall residents stated that they liked the food. It is recommended that the home uses more fresh produce rather than frozen products. One resident is now on liquidised food and the home is completely liquidising the whole meal. The guidelines need to be followed whereby each food item is separately liquidised, thereby still retaining the colour, flavour and nutrition of each food item. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has both a complaints policy and procedure and an adult protection policy and procedure. EVIDENCE: The home has a complaints policy and procedure, which describes how residents can make a complaint and how they can contact the CSCI. A view of the complaints book showed that no complaints had been received. An adult protection policy and procedure has been produced. The majority of staff have now attended training in protecting vulnerable adults from abuse. Two staff attended this training in March 2006. There are no known current adult protection concerns within the home. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19, 22 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical environment of the communal areas within the home needs improving. Additional adaptations have been completed. On the day the home was found to be clean and tidy. EVIDENCE: The communal areas within the home, which include the lounge and dining room, need redecorating. The owner/manager stated that the dining room is due to be redecorated in May. The home also needs to look at improving the environment in the lounge. Most residents spend a lot of time in the lounge and chairs are placed around the edge of the room so that they can view the television. This room is very cluttered with various pieces of large furniture and a piano taking up room in the bay window, consequently residents do not have a view out of the window. It is important that residents have a pleasant and relaxing environment to sit in and it will be required that the home make better use of the space in this room and free up the bay window area to provide more alternative seating. It is not necessary for residents to be Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 15 constantly seated around the television, particularly when they are not even watching it. Some of the armchairs are looking very worn and need replacing. Since the last inspection an occupational therapist carried out an assessment on the home to ensure that residents have the additional adaptations they needed. An extra stair rail has now been added. On the day of this visit the home was found to be clean and tidy with no offensive odours. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a reasonably stable staff team. Fifty per cent of staff have obtained NVQ qualifications. The home carries out suitable recruitment procedures. Staff are receiving adequate training. EVIDENCE: The home has retained all but one of its staff team since the last inspection in December 2005. There are currently fifteen residents with four staff on duty in the morning and three staff for the afternoon. There are a few residents whose level of need has increased and the owner/manager needs to ensure that the home is adequately staffed during the busier times of the day. Four staff were spoken to during the day and they all said that they felt reasonably well supported. Some said that on occasions there had been only two staff on duty in the afternoons and this had been too much work for two people. Workloads have improved now there are three staff on duty. Some staff members said that they are trying to stimulate residents more but at times it was difficult as their dementia states were deteriorating at different levels. All staff said that they had access to relevant training. The current staff appear to be working together well as a team. Four staff have obtained their NVQ qualifications in social care and a fifth member is currently undertaking NVQ Level 2 training. The importance of Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 17 providing all staff with dementia training was discussed and the owner/manager stated that two staff have attended training days in dementia awareness and other staff are booked to attend the training later in the year. Other training courses staff have attended include adult protection and food hygiene. Staff recruitment files were looked at and they all contained the required information. One new staff member has obtained a POVA First check prior to commencing work in the home and she is working under supervision until the CRB check is returned. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run by a qualified owner/manager. The Quality Assurance programme is improving. Resident’s monies are safeguarded in the home. Fire drills still need to be carried out more frequently. EVIDENCE: The owner/manager obtained the Registered Managers Award in 2005 and she has been running the home for a number of years now. She is also a Level 1 Registered Nurse with psychiatric training. Some residents, visitors and staff all stated that they felt comfortable approaching the owner/manager if they had any concerns or complaints. The home carries out its own self-audit once a year, where all the standards are covered. A resident’s satisfaction survey needs to be carried out again with Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 19 assistance from family and friends. Staff supervision sessions are slowly being completed. All staff have now received one session and two staff have completed two sessions. The owner/manager is aware that staff must receive a minimum of six supervision sessions per year. A tour of the premises was carried out to ensure that all health & safety standards are being met. The radiator cover in the ground floor toilet needs stabilising, as it is not fixed to the wall securely enough. The home has devised a new form to record fire alarm checks and emergency lighting and this was viewed. Fire drills involving residents and staff need to be carried out on a more regular basis. Twice a year is not sufficient. All fire doors and corridor doors within the home have safety magnetic closures installed to prevent the spread of fire between floors and rooms. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 Requirement That the home include more indepth service user histories in all care plans. This will ensure that service users hobbies and interests are recorded and acted upon. That the home provide certain service users with a broader range of activities that they will enjoy participating in. To comply with the current guidelines regarding the blending of service users meals. That the environment in the lounge room is improved to provide more access and alternative seating areas for service users. That both the dining room and lounge room are redecorated and reorganised and some of the armchairs replaced. That the radiator cover in the ground floor toilet is securely fixed to the wall. That fire drills/evacuation drills are carried out more than twice a year. Timescale for action 10/06/06 2. OP12 16(2)(m) 10/06/06 3. 4. OP15 OP19 16(2)(i) 23(2)(a) 10/05/06 10/08/06 5. OP19 23(2)(b) 10/10/06 6. 7. OP38 OP38 23(2)(b) 23(4)(e) 10/05/06 10/06/06 Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 22 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. 2. 3. Refer to Standard OP15 OP27 OP30 Good Practice Recommendations That the home tries to ensure that more fresh produce is included into the diet of service users. That the home maintains sufficient staff numbers at all times. That the owner/manager continues to ensure that all staff attend dementia training. Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Sussex Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Aspen House DS0000014175.V289636.R01.S.doc Version 5.1 Page 24 - 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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