Inspection on 19/10/05 for The Ashurst

This inspection was carried out on 19th October 2005.

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

The Ashurst 27/06/07

The Ashurst 24/01/07

The Ashurst 06/04/05

The Ashurst 17/11/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Ashurst, The 1 Kirkley Cliff Lowestoft Suffolk NR33 0BY Lead Inspector John Goodship Announced Inspection 19th October 2005 10:00 Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 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 Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 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. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashurst, The Address 1 Kirkley Cliff Lowestoft Suffolk NR33 0BY 01502 519222 01502 537406 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 A T Wight Mrs Joanna Louise Jay, Mr Martin Edward Jay Mrs Gillian Elaine Murrell Care Home 17 Category(ies) of Learning disability (17), Learning disability over registration, with number 65 years of age (5) of places Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Five persons, over the age of 65, whose names were made known to the Commission for Social Care Inspection in November 2004. 6th April 2005 Date of last inspection Brief Description of the Service: The Ashurst is a residential care home for 17 people with learning disabilities. The home is located in a residential area of Kirkley south of the coastal town of Lowestoft and is close to the beach, pier, marina, local shops, churches and amenities. The accommodation spans three floors served by a shaft lift. There is one double bedroom, the remaining are single. All bedrooms have a wash hand basin and six bedrooms have en-suite facilities. The front windows of the home on the first and second floors offer excellent views of the North Sea. The home offers three communal rooms on the ground floor where service users meet friends and relatives, participate in crafts, hobbies or board games or watch television. There is also a small room for private meetings. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The registered manager and one of the providers who works in the home were present throughout. A number of residents were in the home at the time, and spoke freely to the inspector. They were all happy with their lives and clearly treated the home as theirs. Eight comment cards were received from residents, although in all cases they had been helped by a member of staff. One had signed their own card. Six cards were received from relatives and their comments have been used in the report. The inspector was also shown the work underway in converting a staff flat into two new resident rooms. This is subject to a separate application by the home and is not assessed in this report. The visit lasted 6.5 hours. There were no requirements or recommendations from this inspection. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations from this inspection. The home however intends to continue its development plan, and to seek Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 6 registration for its places to be dual registered, for younger adults and for older people with learning disabilities. 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. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 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 Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 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): 2,3,4,5. Prospective residents are assured that they will only be admitted to the home if it can clearly meet their needs. EVIDENCE: There were clear criteria for admissions and introductory visits. Records of the two most recent admissions showed evidence that these criteria and procedures had been followed. In addition, current residents were consulted about any proposed new resident. A full assessment was made before any new resident was admitted, including the most recent assessment by Social Care Services. Regular reviews ensured that individual needs continued to be met. Contracts were agreed with the funding authority, and each resident had their own terms and conditions which were kept in the care plan. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. Residents take part in care plan reviews to ensure their needs and wishes are acted on. Residents contribute to the running of the home to make sure it is run for their benefit. EVIDENCE: Care plans were reviewed annually or more frequently if circumstances changed. Residents were encouraged to play a part in the day-to-day activities of the home, according to their abilities. They were expected to keep their own rooms clean and tidy, and to take turns in helping with aspects of laundry and laying of tables. Residents appeared comfortable when speaking to staff and would be able to express any issues. The manager said that meetings were only held to discuss specific topics, such as the coming of a new resident, Christmas activities, or changes to the house. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,17 Residents are supported to take part, individually and in groups, in many day and evening activities, inside and outside the home. The minibus increases the flexibility of outings and gives residents more choice. EVIDENCE: Many of the residents attended day centres. Some, because of their age or inclination, chose to stay in the Home. The staff tried to encourage them to go out shopping, or walking, or for lunch, to keep healthy. One resident was able to go the shops and the bank on their own. The Home had the use of a minibus. This had given residents and the home a wider variety of activities to experience. Only a small number could travel each time. This prevented the residents being seen as a group, and gave them the chance to plan the destinations when it was their turn. Staff supported residents to maintain contact with their family. One relative said in their comment card that they could not visit the home but the staff sometimes took their relative to see them. Another said that they were always kept informed about their relative although they could not easily visit. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 11 Nutrition advice had been given by the day centre, and staff encouraged residents to eat healthily. However, in the end the staff were clear that it was the resident’s choice what they ate. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 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): 18,19,20,21. Residents’ health and wellbeing is carefully monitored for early action if needed. Residents have been able to stay in the home as they reach 65, and the home is able to care for and support them. EVIDENCE: The manager said that the home was well supported by the Community team. Advice on special issues was available from a number of sources. Nutrition advice was available by the dietitian from the day centre. This had been accessed to give advice to residents on healthy eating. However the manager stressed that it was for the resident to choose to accept the advice, staff could only encourage and support. Staff supported residents to maintain personal hygiene. An example of this was observed during the inspection. Help was also available from the clinical psychologist on managing challenging behaviour, which sometimes was exhibited at a minor level by a resident. None of the residents had charge of their own medication. A check of the MAR charts showed that all administrations had been signed for. All lotions and creams were identified to a resident. The home had been registered for five named people over 65 years of age. The eldest was 79. The home had applied for a variation to its registration to allow Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 13 all its places to be registered for older people to ensure that current residents could be assured of a home for life, subject to any changes in their needs. Two residents were showing early signs of dementia. They were being assessed by the community team. Both were under the consultant but had not yet been diagnosed. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 14 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. Residents have their views actively sought, and any concerns they have are acted on immediately. EVIDENCE: There was a complaints policy, and the complaints log showed that no complaints had been received in the last twelve months. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 15 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 Residents enjoy a safe and well maintained environment which is being improved to increase the facilities and brighten the communal areas. EVIDENCE: Since the last inspection, one additional bedroom had been created on the first floor from a staff sleep-in room. The opportunity was taken to provide this room and the two adjoining rooms with en-suite facilities. One wall of the dining-room had been knocked out to make it a more open and lighter area. The plan was to knock down the wall into the current office to give a clear view through to the front. Part of the smaller lounge had been closed off to provide a private meeting room. This reduction in communal space would be compensated by the enlargement of the main lounge to take in both bay windows. The two residents who shared a double room used two rooms, one as a sitting room and the other as a shared bedroom. The two people had lived together for many years and were comfortable living together. Rooms were full of residents’ own items, for recreation and decoration. All communal washing facilities now had soap dispensers and paper towels. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 16 An application had been made to the Commission for Social Care Inspection to register two more bedrooms on the first floor, by converting a staff bedsit. This will be dealt with separately. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 17 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. Staff are properly recruited, trained, and supervised to support and protect the residents. EVIDENCE: The file for the newest member of staff contained all the recruitment documents required for the protection of residents. There was a planned programme of two-monthly supervision for staff. Training for NVQ was on-going with 5 staff having completed Level 2 or above, and 4 staff about to start Level 2. In addition, 3 staff were doing the Foundation course and one was on the Induction course. The manager had organised for all staff administering medication to attend a refresher course this year. The continence adviser was booked to discuss the promotion of continence with the staff. The community nurse was booked to talk about the needs of people showing signs of dementia. There were three staff on during the day, with one person sleeping in at night. In addition, the home had been funded to provide a one-to-one person to support a resident on the day they did not attend a day centre. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 18 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): 37,38,39,40,41,42,43 The home is run in the best interests of each resident, with proper systems in place to assure their health and safety. EVIDENCE: The registered manager is responsible for the management of care, supported by one of the owners who undertakes administrative, maintenance and budgeting responsibilities. The manager described the methods by which she and the owners assured the quality of the service. These included staff supervision and appraisal, staff meetings and training, regular updating of care plans with the resident and external professionals, residents’ meetings on specific topics such as a new resident, Christmas activities, and changes to the house. The home now had a full-time maintenance person who could act on any request from a resident about repairs. A questionnaire about the choice of food had recently been sent out and action taken to meet the comments. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 19 A fire risk assessment had been completed in August 2005. One member of staff had been designated as the health and safety officer. Part of their duties included the regular check on the fire extinguishers and fire exits. The home had all the recommended policies in place. Some of them were due to be reviewed. Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 3 Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashurst, The Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000059596.V257670.R01.S.doc Version 5.0 Page 21 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 Ashurst, The DS0000059596.V257670.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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