Inspection on 25/04/05 for Aspen House

This inspection was carried out on 25th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 03/11/08

Aspen House 28/11/06

Aspen House 06/01/06

Aspen House 26/01/05

Aspen House 05/05/04

Aspen House 01/12/03

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

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

CARE HOME ADULTS 18-65 Aspen House 277 Wellingborough Road Rushden Northants NN10 9XN Lead Inspector Helen Wilson Unannounced 25th April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aspen House Address 277 Wellingborough Road Rushden Northants NN10 9XN 01933 419345 01933 419456 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) Community Care Solutions Limited Mr David William Finan Care Home 10 Category(ies) of (LD) Learning Disability 10 registration, with number (MD) Mental Disorder 4 of places (PD) Physical Disability 1 Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No person who falls within the category of Physical Disability (PD) may be admitted to the home when one person who falls within category PD is already accommodated in the home No person who falls within the category of Mental disorder (MD) may be admitted when four persons who fall within category MD are already accommodated in the home Any service user admitted to the home who falls within category PD or D must also fall within category LD ie. dual disability Date of last inspection 26.01.05 Brief Description of the Service: Aspen House is situated in a residential area of Rushden in Northamptonshire. The home is within walking distance of Rushden Town Centre where community resources include shops, pubs, swimming pool and restaurants. The home is owned by Community Care Solutions Ltd and is registered to provide personal care for ten adults with learning disabilities including up to four people with additional mental health problems and one person with additional physical disabilities. Service users with more challenging behaviours are accommodated in the rear unit of the home. The home is divided into two units, the rear unit being known as Aspen Lodge, each area having a kitchen, dining area and lounge. Accommodation to service users within the front unit of the home is provided across two floors; accommodation to service users at the rear of the home is all at ground floor level. The home has rear and side gardens accessible by the service users and a parking area for the home’s vehicles to the front of the house. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The inspection was unannounced spread over two half days, 25 and 26 April 2005, lasting in total eight hours. During the first visit the home was in the charge of the Deputy Manager, discussions and checking of records were held with him and conversation held with people living at the home and staff. Further discussion was held with the Registered manager on the second day and issues discussed regarding the first visit. The Area Manager for the company also visited the home to provide additional information to the Inspector. The primary method of inspection used was ‘case tracking’ which involved selecting one recently admitted service user and tracking the care received through review of the case records. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. What the service does well: People living at the home benefit from homely, comfortable surroundings and single bedroom accommodation. Transport is on hand for trips out and for travelling to day services based mainly in Bedford. Visits to and from families are arranged regularly. The staff team has a good balance of both male and female carers. Staff are friendly and communicate well with people living there. People living at the home generally say they are happy and they look confident when talking to members of the staff team. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The admission process is very good however the contracts given to each person living at the home are not appropriately written and potentially not able to be understood. Staffing levels and levels of staff qualification and experience are still not shown in the home’s Statement of Purpose. EVIDENCE: A case file reviewed evidenced that there had been a pre-admission routine that included 2 visits to the home by the potential service user accompanied by a care manager from the Placing Authority and assessments and care plans drawn up between the service user, the care manager and the home’s manager before the actual admission into the home. Paperwork describing the home and its facilities had been sent out prior to visits however the home’s documentation does not state the number of staff on duty on shifts and no details are given of staff qualifications or experience and potential service users and Placing Authorities will not be given vital information about the way the home is run. This is an unmet requirement from previous inspections of May 2004 and January 2005 and urgent action must now be taken. All service users have been issued with a contract stating terms and conditions. However the wording is not clear and details of extra charges are not spelled out to service users at the home. The issue regarding extra Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 9 charges was made a requirement of the January 2005 inspection and has not been dealt with by the home. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6.7 and 9 Although care plans are reviewed, risk assessments are not updated regularly and therefore staff lack guidance in dealing with the changing risks and needs of the people living at the home. EVIDENCE: Although initial care plans were in place and daily activities planned around the needs and interests of one specific service user, staff confirmed they find it difficult to motivate and stimulate the individual to become involved. Written risk assessments were agreed and drawn up on admission of this service user in September 2004 but these now need to be brought up to date to show changes. There was evidence in one case file, confirmed by talking with the service user and the home’s manager, that the reality of living at the home has not been successful for the service user. Following a formal review steps are being taken to find a more suitable home. The service user confirmed that the home is being helpful with this. The home acts as appointee for nine service users and on their behalf receives their state benefits. The general statement in individual service user’s Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 11 contracts says that up to 50 of each person’s Disability Living Allowance is charged towards transport costs was discussed and the home’s manager agreed that few people living at the home would be able to understand this concept of financial charges. Therefore for the further protection of these vulnerable service users and of the home, the registered manager is strongly recommended to involve independent advocacy services to explain and discuss matters with the individuals. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 14 Activities at the home do not consistently meet the clients’ needs and are dependent on the competency and enthusiasm of staff working on individual shifts at the home. EVIDENCE: Staff said they had taken service users out shopping for clothes during the weekend and locally to spend personal allowances. During the first visit on the Monday, service users said that they had been expecting to be taken out by staff in the home’s minibus but this had not happened. The Deputy Manager explained that the planned trip out had been delayed as he was waiting for delivery of new prescription medication for one person and then secondly for a Community Nurse to visit two service users in the afternoon. Two people said they were bored hanging around watching television with staff. The atmosphere in the home on the second afternoon visit was different and well-organised with service users out at day activities or at home proactively working with staff. It is significant that the home’s manager was available within the home on the second visit to drive the day’s routine and enthuse the staff team. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 13 Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This area was not assessed. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The system for saving service users’ monies is poor and does not pay interest. This is considered to be potentially abusive. EVIDENCE: The home’s manager has been told by his Head Office that service users’ monies are held on their behalf in a non interest bearing account. This is not acceptable practice as individual people have therefore lost potential income from their savings. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, and 29 The home is in good order and service users live in homely and comfortable surroundings. EVIDENCE: The home was homely, clean and there were no odours in the communal areas. The furniture was in good order. Specialist equipment has been supplied to the home by the Community Occupational Service to help one service user with bathing and toileting. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32,33,34,35 and 36 The recruitment practices of the home are not sound and potentially may not protect service users. Formal recorded supervision of staff has improved. EVIDENCE: From file details there was no written evidence that two recently employed care workers had obtained satisfactory Criminal Record Bureau enhanced disclosure checks. The home’s manager thought that his Head Office would only have employed these carers if the checks had come through but was not able to give proof that this was the case. The company’s own policy that states that the home’s records will show that CRB checks have been received by the Head Office, has not been followed in these instances. Staff confirmed that they hold employment contracts and job descriptions and understand their responsibilities. Several staff are new to the home and two said they had had induction training within the home. One carer said that he was learning about the client group and felt supported in his role by his colleagues and manager. A Community Nurse visiting the home said that she had noted increased numbers in the staff team although several carers were inexperienced and learning on the job. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 18 Training records were not checked on this occasion but the home’s manager will be asked to produce individualised training needs assessments for each staff member at the next inspection and to evidence training and development of the staff team. The Deputy Manager has recently been made responsible for supervision of some junior staff and has been given training in this new role. Records of supervision confirm that the majority of staff have received recent formal sessions on a two-monthly cycle from either the home’s manager or the Deputy. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 41 The effectiveness of the staff team from one day to another was seen to be reliant on the level of direction and motivation from the manager on duty and in charge of the home. EVIDENCE: There was a lack of direction for staff during the first visit coupled with a lack of transport and planned activities for the service users. Staff were not motivated or actively encouraging activities or talking with service users. This was discussed with the home’s manager on the second visit for him to remedy. Cash held in the home for service users was counted however records of the spending of service users’ monies were not available at the home to check. The home’s manager had taken the written evidence of how monies had been spent away from the home so that he could enter transactions in the files during his off-duty hours. Records including financial transactions must be Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 20 available for inspection at any time on the premises and the practice of taking records home after working hours will no longer happen by agreement with the manager. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 1 3 1 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x 3 x Standard No 11 12 13 14 15 16 17 x 1 1 1 x x x Standard No 31 32 33 34 35 36 Score 3 3 3 1 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Aspen House Score x x x x Standard No 37 38 39 40 41 42 43 Score x 1 x x 1 x x C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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 5 Regulation 5(1)c Requirement Each service users Statement of Terms and Conditions must identify and detail specifically the amounts to be charged for extra services. This is an unmet requirement from the previous reports with an original timescale of 1 April 2005 The homes Statement of Purpose must identify the staffing levels deployed at the home and detail the level of relevant experience/qualifications of staff. This is an unmet requirement from previous reports with an original timescale of 15 July 2004 Risk assessments for all service users must be regularly reviewed and updated in writing to guide and direct staff and to minimise risks to service users. There must be a managed, consistent approach across shifts to ensure that staff engage service users in interesting meaningful activities It must be demonstrated how each individual service user will receive any interest applicable to Timescale for action 30 June 2005 2. 1 and 3 4(1)c Schedule 1.4 30 June 2005 3. 9 12,13 30 June 2005 4. 12, 13 and 14 12, 14, 15, 16(m and n) 12,20 30 June 2005 5. 23 31 July 2005 Page 23 Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 their individual savings. 6. 34 19 There must be written confirmation of each staff members satisfactory Criminal Records Bureau enhanced disclosure check held at the home prior to the commencement of employment 30 May 2005 7. 8. 9. 10. 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 7 Good Practice Recommendations It is recommended that independent advocates be sought to further assist service users where appropriate regarding financial issues. Aspen House C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Newland House Campbell Square Northampton NN1 3EB 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 C51 S12696 Aspen House V223319 250405 Stage 4.doc Version 1.30 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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