CARE HOME ADULTS 18-65
Aspen House 277 Wellingborough Road Rushden Northants NN10 9XN Lead Inspector
Mrs Helen Wilson Unannounced Inspection 6th January 2006 13:25 Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 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 DS0000012696.V277451.R02.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 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 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) Community Care Solutions Limited David William Finan Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (4), of places Physical disability (1) Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 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 MD must also fall within category LD ie. dual disability 25 April 2005 Date of last inspection 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 DS0000012696.V277451.R02.S.doc Version 5.1 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 on a Friday afternoon and lasted approx three hours. Discussions were held with the Registered Manager and conversations held with seven service users. Selected records were examined relating to the running of the home and individual service users. A brief tour of the front unit was made with the manager and a service user joined this walkabout to show the inspector around various communal and bedroom areas in the rear unit, Aspen Lodge. There are currently nine people living at the home. Recent pre-inspection questionnaires returned to CSCI by two families and nine service users showed that the home was considered to provide a good level of service to its clients and did not raise any specific areas for development. Requirements and/or recommendations identified at the previous inspection were reviewed. There were no immediate requirements or recommendations made at the time of the visit. Two recommendations are stated in this report. What the service does well:
The staff team has a good balance of both male and female carers and staff members are divided into two separate unit teams each led by a deputy manager. This provides consistency for the people living in both units within the home. Staff are friendly, communicate well with people living there and are knowledgeable about service users’ routines and interests. Service users are very confident in conversation with staff and able to make their wishes and needs known and in turn receiving appropriate help and guidance. Each service user has had a recent review of his/her placement with placing authorities’ involvement and care plans and risk assessments have been revised where appropriate.
Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 6 There is a planned weekly activity programme for all service users that includes college attendance for some people. Four service users were going out to their Friday afternoon Corner Club for a music and dance session. Three people were staying at home with staff and one person was out on a day placement and shortly due to return with staff. 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 DS0000012696.V277451.R02.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 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 the following standard(s): 1,2,3,5 The home’s documentation and the admission processes give clear information to prospective service users about the home. EVIDENCE: The statement of purpose has been revised but the Registered Manager still needs to include full details of the staffing levels operated on shift at the home. The manager has undertaken to include this information in the document. Service users are informed in writing of charges that are to be made for extra services such as transport costs. There have been no recent admissions however the case file records for current service users evidence that care needs of individuals are thoroughly assessed. From recent pre-inspection questionnaires returned to CSCI by two families and nine service users comments showed that the home was considered to provide a good level of service to its clients. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 9 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 the following standard(s): 6,7,8,9 The home provides care and support planned around the individual service user’s needs. EVIDENCE: Each service user has had a recent review of his/her placement with placing authorities’ involvement and care plans and risk assessments have been revised where appropriate. All records concerning monies belonging to the service users are kept on the premises and individual service users now have an interest bearing bank account for individual savings. On checking records it was noted that several users still have substantial amounts of personal monies held in non-interest bearing accounts and available for saving; it was discussed and recommended to the Registered Manager that unused monies should be more regularly transferred to savings accounts of the individual to attract interest. The home has arranged for one service user to have an independent advocate to help in understanding financial issues. Service users and staff meetings are held and minuted.
Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 10 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 the following standard(s): 11,12,16 The home supports service users to have ordinary and appropriate lifestyles. EVIDENCE: Service users are very confident in conversation with staff making their wishes and needs known and in turn receiving appropriate help and guidance. There is a planned weekly activity programme for all service users that includes college attendance for some people, swimming, riding and gardening interests.. Four service users were going out to their Friday afternoon Corner Club for a music and dance session. Three people were staying at home with staff and one person was out on a day placement and shortly due to return with staff. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 11 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 the following standard(s): EVIDENCE: These standards were not assessed. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 12 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 the following standard(s): 22,23 The home has robust procedures for ensuring the protection of service users. EVIDENCE: The home has a clear complaints procedure made known to all service users. There have been no recent recorded complaints. Incident reports for the preceding six-month period were examined. It was clear that procedures were followed for planned minimal staff intervention in physically challenging situations. The Registered Manager agreed to ensure that copies of specific incident reports affecting the welfare of service users are routinely forwarded to CSCI Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 13 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 the following standard(s): 24,25,26,27,28,30 The environment has been updated, is bright and suitable for the clientele of the home however the home must improve the heating in the conservatory. EVIDENCE: Wooden flooring has been laid in communal areas of both units, new lounge furniture brought into the front lounge, the existing lounge suite transferred to the lounge in Aspen Lodge, new tables and chairs provided in both dining rooms and redecoration maintenance carried out throughout areas viewed on this inspection. The temperature in the conservatory was inadequate for this room to be used by service users. Arrangements for the installation of appropriate heating in the conservatory were discussed with the Registered Manager since service users now regularly use this room for activities. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 The staff team, experience, qualifications and practice demonstrate that service users’ needs are being met. EVIDENCE: The staff team has a good balance of both male and female carers and staff members are divided into two separate unit teams led by a deputy manager. This provides consistency for the people living in both units within the home. The home provides some service users with additional staff support on a daily basis. The home when necessary continues to employ agency staff known to the service users and working Alongside permanent staff on shift. Since the previous inspection the Registered Manager has arranged weekly management shifts for both deputy managers to develop their skills in procedures and running of the home. Staff records to confirm checks have been carried out before employment are available. Staff are friendly, communicate well with people living there and are knowledgeable about service users’ routines and interests.
Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 15 Service users are very confident in conversation with staff making their wishes and needs known and in turn receive appropriate help and guidance. Staff training follows a yearly plan with staff undertaking refresher courses routinely. Pre-inspection returns state that currently 50 of staff members hold National Vocational Qualifications and another seven people are undertaking NVQ at Level 2 and 3. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,41,42 The home is well managed and service users’ needs and interests promoted. EVIDENCE: An Area Manager visits the home monthly and checks that the home is being run and operated to satisfy the company’s procedures. Recent monthly reports forwarded to CSCI confirm that medication, vehicle, water temperature, room temperatures and call system checks are been carried out weekly and that fire protection and fire evacuation procedures, maintenance tours are carried out and emergency lighting checked on a monthly basis. The Registered Manager gives a clear style of leadership and direction to staff and relates well to service users. Records were clearly written and up to date; case files well organised and used on a daily basis by staff. Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 N/A 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 x 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 3 3 x x 3 3 x Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 18 No 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. Standard Regulation Requirement Timescale for action 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 YA7 Good Practice Recommendations It is strongly recommended that, in order for service users to receive the full potential of bank interest on savings, arrangements are made to reduce amounts of personal monies held unused in non-interest bearing accounts. A permanent method of heating the conservatory room in Aspen Lodge should be provided now that this area is being used regularly by service users. 2 YA24 Aspen House DS0000012696.V277451.R02.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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