Inspection on 30/08/06 for Aston House

This inspection was carried out on 30th 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

Aston House 28/07/08

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Aston House 16 Queensberry Road Kettering Northamptonshire NN15 7HL Lead Inspector Irene Miller Unannounced Inspection 30th August 2006 08:15 DS0000065810.V308808.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 DS0000065810.V308808.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. DS0000065810.V308808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aston House Address 16 Queensberry Road Kettering Northamptonshire NN15 7HL 01227 768231 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) korosso@btopenworld.com Mr Marko Raphael Korosso Mrs Elizabeth Mary Margaret Wallis Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000065810.V308808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration No additional conditions of registration apply. Date of last inspection Brief Description of the Service: Aston House is a five bed roomed single storey building situated on Queensberry Road Kettering. The house is of Victorian design in keeping with other properties in the area, and is close to Kettering train and bus stations, shopping and leisure amenities. Aston House provides comfortable accommodation for up to five people between the ages of 18-65 years of age with learning difficulties. Residents have single living accommodation, one bedroom has en-suite facilities and another has sole use of a separate shower and WC facilities, in addition there is one bathroom on the first floor and a shower and WC on the ground floor. There are two communal lounges, one dining room, a large kitchen diner and a landscaped rear garden. The current scales of charges are in the region of £1,200 to £1,700. DS0000065810.V308808.R01.S.doc Version 5.2 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 upon outcomes for Service Users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for adults (18-65). Prior to the inspection taking place the Commission for Social Care Inspection sent out to the home a pre-inspection questionnaire this was returned to the Commission for Social Care Inspection and supplied additional information on the management systems in place. The primary method of inspection used was ‘case tracking’ that involved tracking the care of residents through discussion with resident’s staff and general observation of care practices. The residents care plans (that sets out how the home aims to meet the residents personal, healthcare, social and spiritual needs) were viewed. In addition policies, procedures and records in relation to staff recruitment, complaints, medication, health and safety and general maintenance and upkeep of the home were viewed. The inspector spent two and a half hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history. The inspection took place over a period of approximately four hours. What the service does well: There was records of comprehensive needs assessments having taken place, prior to the residents moving into the home and records of ongoing reviews and assessment, through the care programme approach, that had involved support from health care specialists. Residents confirmed that they had visited the home prior to moving in and had a choice on how their bedroom was furnished and decorated. Residents are encouraged to participate in preparing their own foods and drinks, and household chores with minimum support from staff. DS0000065810.V308808.R01.S.doc Version 5.2 Page 6 The systems in place for gaining feedback from residents is good and the complaints procedure, ensures that any complaints are dealt with following the policy and that confidentiality is respected at all times. 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. DS0000065810.V308808.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 DS0000065810.V308808.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): 2 Quality in this outcome area is good. There is sufficient information made available to prospective residents, and their families, to enable them to make a decision as to whether the home could meet their needs and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes statement of purpose, service users guide is made available to all prospective and existing residents and their families. Within the residents care plan viewed there was records of a comprehensive needs assessment taken place, prior to the residents moving into the home and records of ongoing review and assessment, through the care programme approach, which had involved support from a health care specialist. Written contracts of care were in place, that stated the terms and conditions between the home and the resident and had been signed by the resident. On speaking with residents and staff it was confirmed that the prospective residents are encouraged to visit the home prior to moving in, to ensure that their needs can be met and that the home is right for them. DS0000065810.V308808.R01.S.doc Version 5.2 Page 9 DS0000065810.V308808.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 & 9 Quality in this outcome area is good. Residents are provided with opportunities to make everyday choices and are supported in living as independent a lifestyle as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans were individualised and included the resident’s personal aims and objectives and support plans which the residents had signed. There was information available within the care plans on the support and input from health care professionals. The care plans had been reviewed and updated. There were general risk assessments in place that were very detailed and had been recently reviewed. On examination of residents and staff accident reports, there was records of incidents when a resident, that had some visual DS0000065810.V308808.R01.S.doc Version 5.2 Page 11 impairment had fallen within the garden and within the house, no specific risk assessment had been implemented to identify what control measures needed to be in place to identify and minimise any tripping hazards that may have contributed to the falls. Residents were observed preparing their own foods and drinks with minimum support from staff. There were records available of weekly house meetings with residents that included consultation with residents on menu planning, food shopping and housekeeping responsibilities. There were records of discussion with residents on choosing where to go on holidays and leisure activities. DS0000065810.V308808.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): 12,13,15,16 & 17 Quality in this outcome area is good. There are opportunities for residents to lead fulfilling lifestyles both in and outside of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Through discussion with the residents and staff it was established that opportunities are available for residents to attend local specialist centres were they take part in peer and cultural activities. A Resident talked of their leisure time interests such as going to the cinema, listening to music, Karaoke, bingo, quizzes, clothes and food shopping and swimming. It was established through discussion with the resident, staff and records available that individual preferences in terms of leisure activities were fully accommodated. DS0000065810.V308808.R01.S.doc Version 5.2 Page 13 The staff recognise the residents right to experience appropriate, personal relationships and treat this area of the residents needs with sensitivity and respect, one of the residents said that they had recently invited a friend over for a BBQ. There are designated days for residents to carrying out daily domestic tasks such as vacuuming, polishing and tidying their own bedrooms, and the responsibility for food shopping with support from the staff. Records were available of resident’s food likes and dislikes and nutritional needs, the staff closely monitor any weight gains or losses. Healthy eating is promoted, and fresh fruit and vegetables and low fat alternatives were readily available within the kitchen and food store cupboards. Staff were observed providing support to residents, in a respectful manner that recognised the residents individual skills to be as independent as possible. One resident was observed preparing beverages with a minimum of staff support and there was a homely atmosphere within the home. The menus are planned one week in advance with residents, however residents have the flexibility to change their food preferences and have an alternative on any given day if they so wish. DS0000065810.V308808.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. The personal and healthcare needs of residents are met This judgement has been made using available evidence including a visit to this service. EVIDENCE: The physical and mental health care needs of residents were identified within the care plans and there were records of the involvement of health care professionals such as the psychologist, general practitioner, optician, dentist and chiropodist. There were records of meetings between the residents and their support worker. The medication storage and administration records were seen to be generally in good order, however one medication was out of stock and another out of date. On speaking with staff it was established that the medication that was out of stock was on order and that out of date medication was no longer in use and therefore required returning to the pharmacy. There were records DS0000065810.V308808.R01.S.doc Version 5.2 Page 15 available of a recent pharmacy inspection that had taken place and advice that had been provide to the manager on the storage and administration of medication. Staff confirmed that medication training had been provided and there were records available to evidence that medication training that had been provided for all the staff. DS0000065810.V308808.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. There is a clear and effective system in place for residents and their families, to voice their concerns and be assured that their complaints will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a complaints procedure in place that included the stages and timescales, from a complaint being raised and informed the resident and their representatives of the person whom to address there complains, the procedure contained the contact details of The Commission for Social Care Inspection. All residents have access to the service user guide that contains the complaints policy and other information on the range services on offer within the home. Records of residents meetings included on the agendas the opportunities for residents to raise any concerns or complaints that were not of a personal nature, any concerns or complaints residents may have of a more private nature the opportunities are available for them to be raised direct with the registered manger, their key worker or with any member of the staff team. The system in place for recording complaints, ensured that any complaints are dealt with following the policy and that confidentiality was respected at all times. DS0000065810.V308808.R01.S.doc Version 5.2 Page 17 Through discussion with staff and from notifications received by the Commission for Social Care Inspection from the registered manager it was demonstrated that the management and staff ensure that any concerns, complaints or vulnerable adult protection issues were taken very seriously and acted upon. One complaint had been received by the manager prior to the inspection visit, and written documentation available demonstrated that the complaint had been responded to by the registered provider and registered manager in line with the homes the complaints policy. On speaking with staff they were fully aware of their responsibilities for protecting vulnerable adults, and the Northamptonshire Inter Agency Vulnerable Adults Policies and Procedures was available for guidance should there be a need to refer to it. DS0000065810.V308808.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. The standard of the environment within this home is good, however there is further work needed to enhance the homes décor to make it a more homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is of domestic layout situated in a residential area within easy travelling distance to the town centre and local community resources. All areas were clean, tidy and well maintained. The individual bedrooms viewed were pleasantly decorated, clean and suitably furnished, containing personal electrical items such as TV, Video, DVD, CD and record player. The two communal lounges within the home were of a good size, each lounge was furnished with two three seater settees, however there was a noticeable DS0000065810.V308808.R01.S.doc Version 5.2 Page 19 lack of curtains, light fittings, occasional tables, clocks, pictures, photographs and other household items that help create a homely environment. The staff said that the curtains from the ground floor lounge were being repaired and curtains for the first floor lounge were yet to be purchased. Steps had been made in purchasing some large wall pictures that were waiting to be wall mounted. On speaking with staff it was explained that the philosophy of the home was to ensure that all residents have a say when choosing items of furniture and colour schemes for the home. Some internal fire doors had been damaged and were not functioning correctly, the staff confirmed that the damaged doors were due to be repaired on the 4th September 2006 this was supported by written documentation available within the home. Work has taken place on improving the garden to include a raised flower border, and several fruit trees within the garden looked healthy and were laden with an ample supply of apples and plums. The patio area led onto a raised lawn which was raise approximately 30cm in height above the patio, this could have the potential to present a tripping hazard, for residents, staff and visitors, therefore consideration should be given to the introduction of a ramp or steps. Records were available and up to date in relation to Health and Safety, food safety, fire prevention and building upkeep. DS0000065810.V308808.R01.S.doc Version 5.2 Page 20 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): 32,34 & 35 Quality in this outcome area is good. There is a trained and experienced staff group to support residents living at the home, however to ensure that residents are fully protected the recruitment procedures need to be more robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff training records demonstrated that there is a commitment to providing staff induction and on going training to ensure that the staff are skilled and competent in caring for the client group living at the home. Minutes of one of the staff meetings included on the agenda cross infection controls and staff had been informed of how to reduce the risks of contracting hepatitis B. The senior staff members on duty on the day of inspection had many years of experience working with this client group and was knowledgeable of the residents needs and individual routines, through observation the residents appeared very relaxed and related well with the member of staff. DS0000065810.V308808.R01.S.doc Version 5.2 Page 21 Through discussion with staff and observation of practices it was demonstrated that the residents are supported by a staff team that are fully aware of their individual routines, needs and preferences, and that there is a commitment by the homes management to ensure that appropriate training is provided. Staff supervision takes place and records were available to view. Staff recruitment files viewed contained evidence that the homes management had obtained the necessary documents in respect of staff working at the home, to include Criminal Records Bureau checks. However within one of the recruitment files viewed, one written references had been obtained and a telephone reference, the telephone reference was not signed or dated by the person who obtained the reference nor followed up in writing as Schedule 2 of the Care Standards Act 2000 regulations require. DS0000065810.V308808.R01.S.doc Version 5.2 Page 22 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): 37,39 & 42 Quality in this outcome area is good. The home is run in the best interests of the residents, however the residents health, safety and welfare could be further protected by improved medication and risk management systems in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents and staff expressed their satisfaction with living and working at the home and the level of support available. The residents care plans were detailed, and recording systems to assess the quality of the service were in place that provided a clear audit trail in line with the policies and procedures in place. Staff and residents meetings take place regularly. DS0000065810.V308808.R01.S.doc Version 5.2 Page 23 Risk assessments were in place for general home safety and these had been reviewed and updated, there were also individual risk assessments in place specific to residents, such as risks of self-harm. However following a number of falls accidents, the homes management had not instigated a risk assessment to assess the severity of the environmental tripping hazards that may have been present to have caused or contributed to the falls The medication storage and administration records were seen to be generally in good order, however one medication was out of stock and another out of date. On speaking with staff it was established that the medication that was out of stock, was on order and that out of date medication was no longer in use and therefore required returning to the pharmacy. There were records available of a recent pharmacy inspection that had taken place and advice that had been provide to the manager on the storage and administration of medication. Staff confirmed that medication training had been provided and there were records available to evidence that medication training that had been provided for all the staff. All care records were kept in a secure place within the home and confidential records were stored securely. The manager was using a vacant bedroom as an office, it is planned that the garage is to be converted into an office, however there was no evidence that work had began on this project. Systems were in place to ensure that resident’s finances were handled appropriately, and money held on behalf of the residents was stored securely. DS0000065810.V308808.R01.S.doc Version 5.2 Page 24 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 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X DS0000065810.V308808.R01.S.doc Version 5.2 Page 25 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 YA20 Good Practice Recommendations The homes management should ensure that residents prescribed medication is in stock and medication that is no longer in use or out of date should be returned to the dispensing pharmacy without delay. The homes management should ensure that the décor and furnishings are completed to include the fitting of curtains and light fittings. Where telephone staff references are obtained these should be followed up in writing prior to the staff taking up employment. 2 3 YA24 YA34 DS0000065810.V308808.R01.S.doc Version 5.2 Page 26 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 © 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 DS0000065810.V308808.R01.S.doc Version 5.2 Page 27 - 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!