Inspection on 03/08/06 for Asquith House

This inspection was carried out on 3rd August 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

Asquith House 31/10/05

Asquith House 27/09/04

Asquith House 04/05/04

Asquith House 27/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Asquith House 8 Waterloo Road Chester Cheshire CH2 2AL Lead Inspector Mr Val Flannery Key Unannounced Inspection 3rd August 2006 03:00 Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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 Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Asquith House Address 8 Waterloo Road Chester Cheshire CH2 2AL 01244 381474 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) www.macintyrecharity.org MacIntyre Care Leander McFadden Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is registered to provide care for 6 service users in the category LD (Learning Disability) The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 31st October 2005 Date of last inspection Brief Description of the Service: Asquith House cares for six adults with a learning disability. It is set in a residential area of Chester close to local amenities and the city centre. The home is on three floors; access between the floors is via the stairway. All the six bedrooms are single, five of which have en-suite shower and toilet facilities. There is one communal shower/bathroom/toilet on the first floor and a toilet on the ground floor. A separate lounge and dining room are located on the ground floor. The garden to the rear of the home provides a well-maintained and secure area for use by service users. Staff are on duty twenty-four hours a day to deliver care to service user. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This • • • key inspection report was written using evidence gathered from the Pre-inspection questionnaire Service history for the home Visit to the home on the 3rd and 11th August 2006 The visit to the home was carried out over five hours and involved talking with six service users, one relative, the home manager and six staff. A number of resident and home records were seen. A partial tour of the building was carried out. Feedback following the visit to the home was given to the manager on the 11th August 2006 What the service does well: The pre-admission procedure, including the statement of purpose and service users guide, ensures prospective service users and their families have the information necessary to make an informed choice about the home. There is a range of information available about service users that show their individual needs have been identified and plans are in place to meet these needs. Risk assessments have been carried out that show how service users can be best supported in the home and in the local community. These also ensure the service users are enabled to choose how they live their daily lives whilst at the same time maintaining their safety and independence. Service users are encouraged to make decisions about their chosen lifestyles, for example, where they spend their leisure time in the home, when they have their meals and make full use of available activities. Relatives are able to visit the home as they wish and are kept informed of events/accidents/incidents that affect service users. Service users’ have access a range of health care services and are supported by staff or relatives when visiting the medical centre or hospital. The complaints procedure has been provided in a format that makes it easier for service user’s to understand. The location of the home makes it easily accessible for relatives and other visitors. Service users are cared for by an established and experienced staff team. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 6 Six service user’s, five relative, two healthcare/other professional and two general practitioners comment cards were returned prior to the visit. Comments included ‘staff are competent and have good knowledge/understanding of service users needs’’ We are always pleased with the care given to (service user) at Asquith House’ ‘Thank you for the care (service user) receives at Asquith House’ ‘ the care staff are giving (service user) is extremely good’. The six service user’s comment cards were completed by staff on behalf of the service users. 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. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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 Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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): 1/2/3/4/5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An up to date statement of purpose is available in the home. This ensures service users and their representatives are aware of the service offered by the home before they make a decision about moving in. EVIDENCE: A requirement identified during the last visit to the home was that an up to date copy of the statement of purpose must be kept in the home. This has been addressed by the home and a copy is now available in the home. Since the last visit to the home no new service users have been admitted. The manager confirmed that the organisation’s pre-admission assessment procedure would be fully implemented for prospective service users. Two service users’ care files were seen during the visit. These showed that changes to their assessed care needs are addressed by the home. Although service users have restricted capabilities changes to the way they are cared for is discussed with them. Three services users spoken with during the visit commented that they’ like it here’. Staff spoken with said service users needs are monitored by staff, and others as appropriate, and care plans are updated to show how any changes are to be met. Care plans seen during the visit showed that changes to service users care needs are recorded in their plans of care. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 9 A copy of the residency agreement between the individual service users and MacIntyre are kept in the home. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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 the following standard(s): 6/7/8/9/ Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care are available that show how the needs of individual service users are identified, monitored and changed as necessary. This ensures staff have the necessary information when caring for service users. EVIDENCE: The two service users’ records seen showed that their assessed needs are included in their plans of care. For example, the level of support they require with using the bathroom, dressing/undressing and moving about the home. During the visit staff were seen helping service users’ and encouraging them to be as independent as possible. During the visit records were seen that showed the home is developing Person Centred Plans for individual service users. These include personal profiles and daily routines for service users. Two service users’ spoken with said ‘staff help them’. Staff were seen asking service users’ where they would like to spend their leisure time, what they would like for tea and what they had done during their daily activities. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 11 Risk assessments are in place that identify possible dangers to service users’. These cover the home environment and when they are using community facilities. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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 the following standard(s): 11/12/13/14/15/16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As the capabilities of service users’ change the staff are supported by the manager to ensure these changes are reflected in the service users’ lifestyle. Service users are enabled to have control over their lives within the limits of their capabilities. EVIDENCE: Three service users’ were seen returning for their daily activities. Records, including a separate diary for each service user which was displayed on a board in the dining room, showed their weekly activity programme. Included in dairy were trips to local shops, cinema and attending a disco. The needs of individual service users’ is such that they require different levels of assistance aspects of daily living. The home has a people carrier that is used to take service users’ on outings to local places of interest. Staff spoken with said the needs and abilities of service users has changed, this in turn ‘put a lot of pressure of staff’ to ensure service users’ lifestyle is maintained. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 13 Risk assessments are in place to ensure the safety of service users when taking part in activities, both in the home and in the community. Staff said service users’ relatives and friend are able to visit the home at any reasonable time and are made welcome. Service users’ record contained details of family contacts and relationships. During the visit a sister of one of the service user’s was spoken with. She said the home and staff are’ excellent’ and that her brother has benefited greatly from living in the home. During the visit staff were seen caring for service users’ by, for example, helping them with personal care and moving about the home. Service users were also seen approaching staff and communicating their needs to them. The record of food offered to service user’ showed that they are offered choices at each meal. During the visit staff were seen asking service users what they would like for their tea. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 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 the following standard(s): 18/19/20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal and healthcare needs are shown in their plans of care. This ensures staff have the information on how these needs are to be met and how they can support service users in a way they prefer. EVIDENCE: During the visit staff were seen offering personal support to service users’ with, for example, using the bathroom/toilet and having a drink. Staff spoken with were aware of the level of help service users’ required with these tasks. Staff were seen encouraging service users to choose a lettuce from the service user’s vegetable patch that is located in the garden to the rear of the home. Records seen during the visit showed that the personal care needs of service users have been assessed and plans are available that show how these needs are to be met. A separate healthcare file is kept on individual service users. These showed that service users receive visits from doctors, nurses and other healthcare professionals. Letters were seen that showed service users are supported by staff to attend hospital appointments as necessary. The record of medication Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 15 administered by staff to one of the service users’ was seen and was satisfactory. During the visit to the home staff were seen caring for service users’ and responding to their requests for help. Staff were aware of the likes and dislikes of service users and how they wished to be cared for. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory procedures are in place to ensure service users are protected from abuse. Service users, and other visitors to the home, have access to a complaints procedure that enables them to raise issues of concern. EVIDENCE: A copy of the complaints procedure is on display in the home. Details on how to contact the Commission for Social Care Inspection are included in the procedure. The manager and staff spoken with said the home has not received any complaints since the last inspection. CSCI has not received any complaints about the home. A copy of the complaints procedure has been provided in picture format that makes it easier for service users’ to understand. MacIntyre have provided an Adult Protection Procedure, a copy of which is kept in the home. Included in the procedure is a copy of the government guidelines ‘No Secrets’. Staff spoken with said they knew about the complaints and adult protection procedures and what to do if a problem arose. They said they would refer any concerns to the senior member of staff on duty. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 17 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): 24/25/26/27/28/29/30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient private and communal space is provided to meet the needs, and suit the lifestyle, of the service users. EVIDENCE: The home is well maintained and is suited to service users’ needs. It is decorated and furnished in a manner that creates a homely and comfortable environment. Since the last visit two bedrooms and the lounge have been redecorated. All the bedrooms are single and five have en-suite bathing and toilet facilities. The two bedrooms seen were individually decorated and furnished. The layout of the bedrooms ensured service users were able to move freely about their rooms. One of the service users said he ‘likes’ his bedrooms A communal toilet is provided on the ground floor, a combined bathroom/shower/toilet is also provided on the first floor. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 18 The home provides one large communal lounge and a separate dining room which are located on the ground floor. The enclosed garden to the rear of the home is well-kept and easily accessible to service users. The home has a people carrier that is funded by the service users who are on the higher rate of disability living allowance. On the day of the inspection home was clean, tidy and free from unpleasant odours. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 19 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): 31/32/33/34/35/36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Staff receive individual supervision and have access to training courses that helps ensure they are enabled to meet the needs of service users. EVIDENCE: Six staff were spoken with during the visit. They confirmed that they receive individual supervision from the manager. They also said they have access to a range of training opportunities provided by MacIntyre. Training records seen showed that the following courses are provided for staff: administration of medication updates, health/safety, risk assessment, fire awareness, first aid, manual handling and POVA. Two staff commented that MacIntyre are a ‘good company to work for’. Staff also said they receive support from senior staff, particularly the senior support worker. The pre-inspection questionnaire showed that five staff have achieved an NVQ. In discussion with staff they confirmed that it is the policy of then organisation that all staff achieve an NVQ as part of their development. A record of staff details that are kept in the home were seen during the visit. These were satisfactory. During the visit staff were seen caring for service users and offering them support and encouragement. Service users were seen communicating their Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 20 needs to staff and were comfortable in approaching staff for assistance with personal care. Staff commented that there are not enough staff and that means existing staff have to work extra hours to cover the rota. They felt that the low level of pay offered maybe a factor in the difficulty of retaining staff. The manager confirmed that, following a recruitment drive, three new staff are due to commence employment in the home. Discussion took place with the manager on the need to ensure the new staff receive a structured induction programme that will allow them time to get to know the service users. It will also help ensure that they, and the existing staff group, will be a more effective team. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 21 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): 37/38/39/42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in that ensure the health and safety of service user’s, staff and other visitors to the home is protected. EVIDENCE: The manager for the home is also responsibility for another home in the Chester area. She is allocated nineteen and a half hours as manager for Asquith House. In her absence the senior support worker confirmed that she carries out a number of management tasks. A number of the staff spoken with said they are ‘happy with the overall management of the home’. The manager confirmed that she had submitted an application to the central registration team of Commission for Social Care Inspection to be the registered manager for the home. During the visit the following records were seen Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 22 : : : : : Checks on the temperature of the hot water Fire Safety Checks Gas Safety Certificate Portable Appliance Tests Risk Assessments The manager confirmed that quality assurance surveys are sent to relatives that request feedback on the level of service offered by the home. She also said senior staff from the organisation carry out a two-day inspection of the home under the heading ‘Big Respect’. Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Asquith House DS0000006528.V300447.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!