Inspection on 14/12/05 for Aspen House

This inspection was carried out on 14th December 2005.

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 10/05/06

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 Unannounced Inspection 14th December 2005 11:00 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.V260415.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V260415.R01.S.doc Version 5.0 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.V260415.R01.S.doc Version 5.0 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 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. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection was carried out over a period of four hours on 14th December 2005. The inspection process included speaking to four residents and a visiting professional, tour of the premises, document reading and informal discussions with the owner/manager and the staff on duty. What the service does well: What has improved since the last inspection? The home has addressed all of the requirements that were made during the last inspection. Most of the internal fire doors have now been fitted with magnetic closures so that in the event of a fire the doors will close automatically. Previously the home was wedging open fire doors, so that residents could get through the doors more easily, however this was causing a fire hazard. The home has now been assessed by an occupational therapist and several recommendations were made and these include providing additional grab rails in communal toilets and additional stair rails. Care plans have improved and they are now much more easier to read and understand. Relevant information is now being included into the care plans. Staff supervisions are improving but they still need to be carried out on all staff at least six times a year. The home has also carried out a self-audit this year, which involved the owner/manager and staff. The home appears up-to-date with core skills training for staff. Several bedrooms in the home have been recarpeted and work is soon to be carried out on making improvements in other areas of the home. Some bedrooms are also in need of redecoration, as is the dining room. Locks are also due to be fitted to the bedroom doors of five residents. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 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.V260415.R01.S.doc Version 5.0 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): 1&3 The home has produced a service users guide. The owner/manager carries out assessments on all prospective residents. EVIDENCE: The owner/manager has produced a service users guide, which was recently reviewed in June 2005. The guide outlines the aims and objectives of the home and also provides information about the environment, care plans, staffing and management of the home. Normally prospective residents are referred to the home via community practice nurses, hospitals and social services. Reports, histories and current assessments are carried out by these agencies before a resident moves into the home. The owner/manager also carries out an assessment to ascertain as to whether the home will be able to meet the person’s needs. Assessments can be carried out either in the persons home or in hospital. The homes assessment covers the area of physical health, mental health and personal information. The home does not provide intermediate care. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 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 & 11 Care plans were found to be up to date. Resident’s health care needs appear to be met. On the day staff were seen to treat residents with respect. The home must record the wishes of residents as regards illness and death. EVIDENCE: A number of care plans were viewed and they appeared to be relevant and up to date. Care plans have improved and they are now more detailed and easier to read. Residents have access to a variety of health care providers, which include their own G.P.’s, Psychiatrist, Community Practice Nurses (CPN), District Nurses, Social Workers, MIND Advocates, Dentist and Chiropodist. A Vicar also comes into the home once a month to perform religious services. Staff also check on the tissue viability of non-ambulant residents to ensure that they do not develop pressure sores. On the day residents were seen to be treated with respect and dignity by staff. The home must record residents wishes regarding illness and death, this is particularly important for residents who do not have any family members or friends. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 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 the following standard(s): 12 & 14 Residents are provided with a number of planned activities during the week. Advocates are provided for residents who do not have relatives. EVIDENCE: During the week the home organises a number of activities for residents. Twice a week music and movement sessions are held and on Fridays there is an arts and crafts session. Sing-a-longs, various board games, videos and the television are also popular with residents. Most of the residents have family members or friends who assist them in exercising choice and control over their lives. Many of the residents now lack the capacity to make their own decisions due to their current medical conditions therefore it is important that those residents who do not have relatives have access to advocates. One resident has a MIND advocate to assist him. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 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 the following standard(s): 16 The home has a complaints 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. To date there have been no complaints made to the home. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 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 the following standard(s): 20, 22, 24 & 26 Communal areas are available to residents. An assessment has been carried out by a qualified occupational therapist. Some bedrooms within the home have been redecorated. EVIDENCE: During the last inspection a requirement was made for the home to have certain internal doors fitted with magnetic closures as they were being propped open with door wedges and this was a fire hazard. To date all doors in the corridors, the lounge and dining room have been fitted with these door closures. Communal areas within the home include the lounge, dining room small quiet room, lobby area and patio garden. Since the last inspection four bedrooms have been re-carpeted and new carpets are to be laid on the landing and stairs. Some of the bedrooms and the dining room are looking a little tatty and are in need of redecoration. This was discussed with the owner/manager. A requirement was made for screens to be made available for rooms that were shared and this has been done. Risk Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 13 assessments have been carried out on all residents in their rooms to see if they are able to manage locks. Previously none of the bedrooms had locks attached. The owner/manager stated that following the risk assessments five residents were able to manage locks on their doors. These locks are due to be fitted onto those bedroom doors soon. A previous requirement was made for the home to be assessed by a qualified occupational therapist and this was carried out on 2nd September 2005. A number of recommendations were made and include more grab rails in the communal toilets, to provide another stair rail for the main staircase and another rail for the three steps leading up to the first floor landing. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 14 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 & 30 The home has a reasonably stable staff team. Staff are receiving adequate training. EVIDENCE: The home now has quite a stable staff team and the owner/manager stated that at present no agency staff are being used. During the morning shift there are normally four staff on duty, one of who has to prepare lunch for the residents. In the afternoon there are three staff on duty. One waking and one sleeping-in night staff are employed during the nighttime period. There are currently fifteen residents; three have medium needs and the remainder have low needs. Three staff were spoken to during the inspection and two staff did feel that sometimes there are not enough staff on duty during the busy morning period. The home has made good improvement in the area of training and all staff are up to date with their core skills training requirements. The next training programme will commence in January 2007. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 15 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): 33, 36, 37 & 38 The Quality Assurance programme is improving, as is the level of staff supervision, although all staff must receive eight sessions per year. Fire Drills need to be carried out and recorded more frequently. EVIDENCE: The owner/manager stated that herself, the deputy manager and two staff members had carried out a self-audit of the home. A resident’s satisfaction survey was carried out in July 2005. Not all residents were able to complete the survey so forms were given to relatives to complete. Staff supervision is now being carried out and recorded. To date four of the staff have now received appraisals and a supervision session. The owner/manager needs to ensure that all staff receive at least six supervision sessions a year. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 16 A number of records were viewed during the inspection. It was noted that fire drills only appear to be carried out once a year. The owner/manager stated that a staff member was responsible for carrying out and recording fire drills every Monday and that the book for recording these events was missing. The home must ensure that these records are made available during inspections. The home must remain vigilant with hot water temperatures; the hot water temperature in Room 9 was found to be rather high. A portable electrical heater was seen in one of the bedrooms. Portable heaters are not considered safe particularly in regards to vulnerable older people who sometimes do not have good mobility or balance. If additional heating is required in the room then it must not present as a risk to residents. It must also conform to all current safety standards. Call alarms and emergency lighting were seen to be checked on a weekly basis. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 X 2 X 2 3 X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 3 2 Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 18 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. 2. 3. Standard OP36 OP11 OP22 Regulation 18(2) 12(2)(3) 23(2)(n) Requirement All staff to receive a minimum of six supervision sessions per year. That the home records the wishes of service users regarding illness and dying. That the home provides all the additional adaptations as recommended by the Occupational Therapy Assessment from 02/09/05. To ensure that fire drills are carried out regularly and recorded and that these records are made available at all inspections. To ensure that any additional heating appliances in bedrooms are correctly installed and are not hazardous to service users. Timescale for action 31/01/06 31/01/06 31/05/06 4. OP38 23(4)(e) 31/01/06 5. OP38 13(4)(a) 31/12/05 Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 19 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 OP24 Good Practice Recommendations To redecorate the dining room and several of the bedrooms. Aspen House DS0000014175.V260415.R01.S.doc Version 5.0 Page 20 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.V260415.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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