Inspection on 20/03/06 for Aston House

This inspection was carried out on 20th March 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Aston House 04/03/09

Aston House 02/09/08

Aston House 22/11/07

Aston House 30/10/06

Aston House 11/08/05

Aston House 22/03/05

Aston House 16/08/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOME ADULTS 18-65 Aston House 45 Hampton Park Road Hereford Herefordshire HR1 1TJ Lead Inspector D Lewis Unannounced Inspection 20th March 2006 11:30 Aston House DS0000024691.V289079.R01.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 Aston House DS0000024691.V289079.R01.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. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aston House Address 45 Hampton Park Road Hereford Herefordshire HR1 1TJ 01432 267996 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) Mr Mark Zylinski Mrs Lesley Ann Pinwell Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2005 Brief Description of the Service: Aston House is a substantial detached property set back from the road in a residential area of Hereford city. The house has 10 single bedrooms, 3 double bedrooms, shared lounge, dining room, bathroom facilities and a good sized garden with a conservatory. The home is registered to offer services for up to 16 adults who have experienced some mental or emotional health problems. For some service users it is their ongoing home, for others it may be less permanent, on the way to more independent living, but for all the aim is to provide a normal, homely and supportive environment. Mr Mark Zylinski, the registered provider, has owned the home since 1988. He is a qualified psychologist and visits the home on a regular basis. The registered manager is Mrs Lesley Pinwell, who has worked at the home for 15 years. Leslie became the home’s manager in 2004 and has completed the registered manager’s award. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For a more complete picture of the home, this report should be read together with the report of the last inspection when other standards were assessed. This routine unannounced inspection took place on a Monday during the lunchtime and afternoon, over 5½ hours. The aim was to follow up progress since the last inspection and to see what the home was like during an ordinary day. The inspector met and spoke at length with 4 service users who were in the home. The inspector also spoke with 3 staff members and the registered manager. There was a relaxed, friendly atmosphere in the home. The inspector also saw the new arrangements for smoking. What the service does well: What has improved since the last inspection? There is now a covered walkway to the smoking room, and a new quiet lounge for visitors or meetings. Damaged areas in the bathroom and WC had been repaired. The temperature of the water and radiators was now controlled, to prevent accidental burns or scalds. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aston House DS0000024691.V289079.R01.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 Aston House DS0000024691.V289079.R01.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): 5 Service users had contracts, but some of these did not accurately represent the services they received. EVIDENCE: The inspector saw contracts and records of payments made by service users. In some cases extra charges were being made for extra items or services. In some cases there was no recorded evidence that service users were getting these extra items or services, and this was verbally confirmed by service users. Aston House DS0000024691.V289079.R01.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): 7 Service users were generally free to make their own decisions. Where the registered provider is involved, independent checks should be carried out. EVIDENCE: There were few limitations on service users. One noted was regarding rationing of cigarettes (for health reasons). This was agreed to by the service user and was recorded. Some service users looked after their own money, others needed staff help. Records indicated that the registered provider was the appointee for 11 of the 16 service users. This is not ideal. The manager was not aware of any independent auditing of these financial records. Aston House DS0000024691.V289079.R01.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): 12, 13, 14, 15, 16 The home should check whether they could do more to support some less motivated service users with activities and leisure, and to take part in the local community. Daily routines were flexible and visitors welcome. EVIDENCE: Records showed that service users were involved in a range of leisure / education /occupation activities. This was confirmed by service users. Levels of activity varied according to motivation, interest and personal preferences. Some service users mainly stayed in the home, others were leading active lives. One person felt bored and said more staff would enable him to have more opportunities for support with activities. Only 4 service users had gone on holiday during 2005. The inspector advised it would be good practice to record all activities individually for each service user, including activities offered but declined. This would highlight whether any individual had a need for further support from staff. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 11 Service users said families were made welcome in the home and visits to families were supported. Daily routines were flexible, with no set times e.g. for getting up, meals etc. Although one person mentioned living to “hospital routines” this was not confirmed by other service users. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 12 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): NONE EVIDENCE: Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 13 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 had satisfactory arrangements for handling complaints and for staff awareness of adult protection issues, although not all service users felt confident in using the complaints procedure. EVIDENCE: The home had a complaints procedure. Service users were aware of it and it was on the notice board. There was a record of complaints, which included relatively minor issues, as is good practice. However not all service users felt confident enough to use the procedure, should they need to. The home had an adult protection policy and almost all staff had been trained. Further training was to be done in June to ensure all staff were trained. Staff showed an understanding of adult protection issues. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 14 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): 27, 28, 30 Bathrooms and WCs now met required standards, though there were less of them than desirable. The home had suitable shared areas, now including a separate smoking area. The home was clean and hygienic. EVIDENCE: Repairs and redecoration had been carried out to bathrooms and WCs, and the inspector was told that water temperature regulators were now in place. The inspector saw the newly converted garage, originally planned as a smoking room but now in use as a quiet meeting / visitors’ room. There was now a covered walkway to this and to the conservatory, which was used as the smoking room. The inspector was told that the conservatory was satisfactory as a smoking room, but would benefit from installation of an extractor as it becomes quite smoky at times. The home had an infection control policy, but was finding it difficult to access training. The laundry was situated away from the kitchen and dining room. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 15 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): 33, 34, 35 Staff levels were on the low side and did not permit much individualised work with service users. The home did not have evidence of always using safe recruitment procedures. Training was mostly in place, with some areas for improvement. EVIDENCE: Staff levels were low, with normally 2 care staff on duty during the day. On occasion there would be an extra member of staff to enable a specific activity to take place e.g. trip to cinema. However this did not allow much flexibility to respond to individual needs for one-to-one support, such as a key worker accompanying an isolated service user into town for shopping or other activity. There was a cleaner 7 days per week and a cook 5 days per week (the home was seeking a weekend cook). At night one person was on duty with another on call. Staff asked said this was acceptable as disturbances at night were rare. The inspector sampled staff records and found some required pre-employment checks were not present. One person’s CRB (Criminal Records Bureau) disclosure could not be found, and not all staff had 2 written references. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 16 The home provided training records to the inspector. Most training was in place for permanent staff, all of whom (except a new starter) had trained in counselling, food hygiene, first aid, medication, protection of vulnerable adults; and all of whom had done, or were doing, NVQ 3 in promoting independence (or NVQ 4 in Care). However no one had done infection control training and only one person had trained in prevention of/ response to aggressive incidents. It did not appear that induction training met Skills for Care (previously TOPSS) standards. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 17 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): 41, 42 Most records checked were in place, but some were incomplete. Health and safety was mostly well managed. EVIDENCE: (Standard 37 – the registered manager confirmed that she had successfully completed her mental health training with the Open University). Some, but not all, records were checked. Of those seen, some were incomplete e.g. staff records, financial records. The inspector was told that health and safety issues previously identified (water temperature regulators and radiator covers) had now been rectified. Other health and safety records were sampled and showed management was generally sound. The frequency of fire drills should be increased to twice a year. Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 18 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 X 2 X 3 X 4 X 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X 2 2 X Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 19 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 YA13 Regulation 16 Requirement Timescale for action 30/06/06 2 YA34 19 3 YA35 18 4 YA39 24 The home must provide sufficient staff to ensure service users are supported to engage in activities of their choice outside the home. Staff must not be employed in 20/03/06 the home until the information required in schedule 2 of the Care Homes Regulations 2001 has been obtained. Staff must receive training 31/08/06 appropriate to their work. Specifically, this must include induction meeting Skills for Care standards; prevention of and response to aggression; and infection control. The home must evaluate the 30/06/06 results from the quality assurance process and draw up a development plan. (Previous timescales of 30/05/05 and 31/12/05 not met, but work in progress) All required records must be complete and up to date. In particular, records must be maintained of the additional charges of £35 per week paid by DS0000024691.V289079.R01.S.doc 5 YA41 17 30/06/06 Aston House Version 5.1 Page 20 6 YA42 23 4 service users and the purpose for which this money has been used. The records must detail the specific goods / services provided, with evidence of the precise amounts spent on each occasion. The records must cover the period from which the first additional payment was made in each case. Fire drills must take place at least twice a year, and all staff must take part in a drill at least once a year. 30/06/06 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 3 4 5 Refer to Standard YA3YA35 YA5 YA7 YA14 YA14 Good Practice Recommendations A basic training programme for staff in relevant mental health topics should be formalised to identify and deliver core topics. (Carried forward from August 2004) The contracts for service users should accurately reflect the services actually provided. Accounts of service users’ finances, where the registered provider is their appointee, should be independently audited. Service users’ holidays should be funded from the home’s budget, not by service users. (Carried forward from August 2005) The home should keep individual records of activities for each service user (including offers of activities which are declined), to enable them to identify any service users needing further staff support. The home should ensure that all service users are aware of the complaints procedure and feel confident that their views will be listened to and acted on. A smoke extractor should be fitted in the smoking area. 6 7 YA22 YA28 Aston House DS0000024691.V289079.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 DS0000024691.V289079.R01.S.doc Version 5.1 Page 22 - 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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