Inspection on 17/06/05 for Aston House

This inspection was carried out on 17th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Aston House 05/09/06

Aston House 11/10/05

Aston House 12/01/05

Aston House 09/06/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOMES FOR OLDER PEOPLE Aston House 14 Lewes Road Eastbourne East Sussex BN21 2BT Lead Inspector Kathy Flynn Unannounced 17 June 2005 11:30 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 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. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Aston House Address 14 Lewes Road Eastbourne East Sussex BN21 2BT 01323 638855 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) Mr Bhye Koomar Mr Bhye Koomar and Mrs Koomar Care Home 15 Category(ies) of Care home (PC) (MD (E)) 15 registration, with number of places Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users to be accommodated is fifteen (15). 2 That service users should be aged sixty-five (65) or over on admission. 3 That service users should have a mental disorder, excluding learning disability or dementia. 4 That one service user aged sixty four (64) to be admitted. This condition will no longer apply once the service user is aged sixty-five (65) years. Date of last inspection 12 January 2005 Brief Description of the Service: Aston House is a care home registered to provide personal supprt for up to 15 older people with past or present mental health needs. A variation of registration has been approved to enable the home to provide for a named resident who is below 65 years of age. The home is situated on a main road in a residential area, within walking distance of Eastbourne town centre and pulblic transport, with GP and dental surgeries accessible. It is on two floors with thirteen single and one double room, there are no en suite facilities, there are two bathrooms, with a shower cubicle in one and additional toilets on each floor. A lift provides access to the first floor with additional steps restricting access to some rooms There are two lounges, one on the ground and one on the first floor, with a dining room the rear of the building. There is an attractive garden to the rear and a patio area at the side of the building that are used when weather permits. There is a small parking area at the front of the building that can be accessed from the road. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The requirements recorded in the previous inspection report were used to develop the plan for this inspection. The aims were to assess if the home had met these requirement, identify the aspects of the service that have improved and how the service could be developed for the benefit of residents. The inspection was carried out over four hours from 11.30am and included a tour of the building, an examination of care plans, staff records, the statement of purpose, terms and conditions for residents and the menu. There were 10 residents at the home during the inspection. The residents and the staff on duty, the joint managers and the cook, were happy to talk about the support provided at Aston House. Activities were not provided at the time of the inspection, however the manager took a number of residents for a walk before lunch. What the service does well: What has improved since the last inspection? Some of the requirements identified in the previous inspection have been met and the manager is aware of the work that is outstanding. The statement of purpose and service users guide have been reviewed and updated to include all the information listed in Schedule 1. The terms and conditions for residents have been reviewed to include details of responsibility for payment of fees. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 standard(s) 1, 2, 3, 4 and 5. Standard 6 is not applicable. The homes statement of purpose is good providing residents and prospective residents with details of the services the home provides enabling them to make an informed decision about admission to the home. EVIDENCE: The statement of purpose and the terms and conditions for residents have been reviewed and the additional information requested following the previous inspection has been included. Appropriate pre-admission assessments are completed for all prospective residents and rooms are only offered if the home can meet their needs. Residents are encouraged to visit the home before they agree to accept a room. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 standard(s) 7 and 10. The staff have a good understanding of the residents’ support needs. This is evident from the positive relationships, which have been formed between the staff and the residents. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: Care plans include relevant information concerning residents, including the assessments completed with social services and the Mental Health Care Team. Risk assessments have not been reviewed for several months and there is no evidence that the residents are involved in the monthly reviews of the daily plan of care. However staff have a good understanding of the residents’ needs and the residents feel that they receive the support they need. They feel they are treated with respect and involved in any decisions taken about the care provided. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 standard(s) 12, 13, 14 and 15. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: There was no social activity provided during the inspection and the manager advised that residents are encouraged to choose how they spend their time. Some are independent and may go out for a walk or shopping, others watch TV or play cards and other games. On the day of the inspection the weather was warm and sunny, several went for a walk with the manager in the morning and some sat on the patio after lunch. A resident explained that she chose to watch TV and enjoyed the morning programmes, others advised that they could spend their time in their rooms if they wished, sit in the lounge, the garden or go for a walk. An Occupational Therapist provides exercises and games every three weeks and there are links with local churches. There is open visiting at the home although there were no relatives or friends visiting during the inspection. Residents are able to exercise personal autonomy. If appropriate, support is provided by the staff to enable residents to make choices about all aspect of their daily life. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 11 There are choices provided for all meals, snacks and drinks are available throughout the day and the times are flexible to meet the specific requests of residents. The residents spoke very positively about the food and praised the cook’s ability to provide excellent meals. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 12 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 standard(s) EVIDENCE: These standards were not assessed at this inspection. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 13 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. The standard of the environment within this home is satisfactory and provides residents with a comfortable, clean and homely place to live. EVIDENCE: Aston House provides comfortable, homely individual and communal space for residents. Rooms are redecorated when empty, residents are encouraged to bring their own possessions to the home and many have personalised their rooms with furniture, pictures and ornaments. One resident chose the colour of paint for his room and was pleased that he could bring some of his own furniture with him to the home. A risk assessment for accessing the rear garden is to be completed to ensure the safety of staff and residents when they use this area. There are sufficient bathrooms and suitable toilets, additional aids can be provided if required and an assessment of the home has been completed by an Occupational Therapist. It was noted that in two of the residents’ rooms the sinks are loose and should be fixed to the wall to ensure their safety. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Since the last inspection the standard of vetting and recruitment practices has declined with appropriate checks not being carried out and potentially leaving residents at risk. EVIDENCE: Recruitment procedures have not been followed for the staff employed by the home since the last inspection. CRB/POVA checks were not provided before staff commenced employment, the legislative requirements were discussed with the manager, who advised that these staff will work under strict supervision until CRB checks have been completed. Discussion concerning references identified the importance of collecting references that are relevant to the applicant and that it is the managers responsibility to ensure that they are satisfied with their authenticity and suitability. They should wherever possible include one from a previous employer. The induction training provided for new staff is limited and should be reviewed and updated to meet current standards. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36, 37 and 38. The management approach to the home is open and encourages the involvement of staff and residents in decisions taken about the services offered at the home. The residents choices and opinions are used as the basis of developing the support and care provided at the home. EVIDENCE: The management approach to the home is open, encouraging staff and residents to be involved in decisions about the care and support provided at Aston House. Staff are supervised on an informal basis as part of the daily management of the home and the managers advised that formal supervision is provided every three months with yearly appraisals. Mandatory training, including manual handling, fire safety and first aid are provided for all staff. Staff training in supporting individuals with a mental Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 16 disorder is provided by the managers as required, although they explained that they are trying to access external providers to support this. Policies and procedures should be reviewed and updated to ensure that staff have access to all relevant information. The doors to residents’ rooms continue to be propped open with stools and chairs. Doors are not to be propped open, a safe alternative system is to be provided for residents’ who wish to have their doors open. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 2 3 STAFFING Standard No Score 27 x 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 x x x 3 2 2 Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 18 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 OP7 Regulation 15 (1)(2) Requirement Care plans to include evidence of residents and their representatives involvement in the review. This is outstanding from 25.02.05. Individual residents risk assessment to be reviewed as part of the care plan. Risk assessment to be completed with regard to access to rear garden. This is oustanding from 25.02.05. Sinks in residents room to be fixed securely. This is oustanding from 25.02.05. Appropriate recruitment procedures to be followed with reference to Schedule 2, to included CRB/POVA checks. Induction training to be reviewed and updated to ensure an appropriate standard is provided. Policies and procedures to be reviewed and updated. This is outstanding from 25.02.05. A safe system of keeping doors to residents open to be provided following consultation with the fire service. Timescale for action 04.07.05 2. 3. OP 7 OP 19 15 (2)(b) 13 (4)(b) 04.07.05 04.07.05 4. 5. OP 24 OP 29 13 (4)(c) 19 (b)(c) 04.07.05 27.06.05 6. 7. 8. OP 30 OP 37 OP 38 18 (c)(i) 17 13 (4)(c) 15.08.05 05.09.05 04.07.05 Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 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. 2. Refer to Standard OP 33 OP36 Good Practice Recommendations Produce a development/business plan for the home. Produce an index/contents page to policies file. Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection 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 Aston House H59 H10 S21035 Aston House V217930 050505 stage 4.doc Version 1.20 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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