Inspection on 06/04/05 for The Ashurst

This inspection was carried out on 6th April 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 19/10/05

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 The Ashurst 1 Kirkley Cliff Lowestoft Suffolk NR33 0BY Lead Inspector John Goodship Unannounced 06 April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. The Ashurst Version 1.10 Page 3 SERVICE INFORMATION Name of service The Ashurst Address 1 Kirkley Cliff, Lowestoft, Suffolk NR33 0BY 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) 07780 685709 Mr A T Wright Mrs Gillian Elaine Murrell Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (5) of places The Ashurst Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Ashurst Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced. The previous inspection had taken place on November 17 2004, when resident and staff records had been looked at in detail. This visit was to check that the Home manager had put right those shortfalls in the national standards listed as Requirements. There were 4 of them. They had all been acted upon. The visit was also to check that the new owners who took over in December 2004 were maintaining the previous standards, and working on improvements. The manager was present for some of the visit, which took 3.5 hours What the service does well: What has improved since the last inspection? The Ashurst Version 1.10 Page 6 No staff can start work at the Home until the manager has assessed by interview and documents that they are suitable, and not a risk to the residents. The documents for all staff are now in place. Staff are now able to discuss their work regularly with the manager, to make sure that they are properly trained, and can provide the best support for each resident. Residents are asked for their views on the Home, sometimes by a questionnaire. This records peoples opinions, about what happens now and about what residents would like to happen. The new owners have started to improve some of the rooms. A bathroom is being redecorated and a new bath has been installed to make it more comfortable to use. There are also plans to increase the number of resident rooms, but no formal application has been made yet. 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. The Ashurst Version 1.10 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 Standards Statutory Requirements Identified During the Inspection The Ashurst Version 1.10 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 standard(s) 1 - 5 The Home meets these standards. There are clear criteria for admissions and introductory visits. Regular reviews ensure that individual needs continue to be met. Contracts are agreed with the funding authority, and each resident has their own terms and conditions. EVIDENCE: The newest resident moved to the home in November 2004. They confirmed that they were able to visit the home, and had chosen the décor for their room beforehand. They also brought in several items of their own furniture. The individual care plans contained a record of the reviews with the resident, their family and social care services. The Ashurst Version 1.10 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 standard(s) 7,8. The home provides good support and encouragement to residents to make choices about their lives and to treat the Home as a home, with accompanying rights and duties. EVIDENCE: The issues of one resident concerning visits to their family were discussed with the manager. The Home has been supportive to the resident in respecting their wishes, and has been working with the family to help them understand the resident’s ability and right to choice. Residents are encouraged to play a part in the day-to-day activities of the home, according to their abilities. They are expected to keep their own rooms clean and tidy, and take turns in helping with aspects of laundry and laying of tables. One member of staff said that The Ashurst felt more like a real home than any other they had worked in. The Ashurst Version 1.10 Page 10 The Ashurst Version 1.10 Page 11 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 standard(s) 11 - 16 Residents are supported to take part, individually and in groups, in many day and evening activities, inside and outside the home. The new owners have bought a minibus to improve the flexibility of outings. EVIDENCE: Many of the residents attend day centres. Some, because of their age or inclination, choose to stay in the Home. The staff try to encourage them to go out shopping, or walking, or for lunch, to keep healthy. One resident returned home during the inspection after walking down the road with a staff member for lunch. It had clearly been enjoyed. The Home now has a minibus. This has given residents and the home a wider variety of activities to experience. Only a small number can travel each time. This prevents the residents being seen as a group, and gives them the chance to plan the destinations when it is their turn. The Ashurst Version 1.10 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 standard(s) 18,19,20 Residents’ health needs were being monitored and the appropriate professionals consulted. Some of the medicine administration charts had not been properly completed. EVIDENCE: Care plans recorded episodes of ill-health, visits from GPs and visits to clinics. There was an appointments book to remind staff. Some residents had their weight checked regularly. One resident returned from the dentist during the inspection. They were helped to have a suitable lunch, and then had a rest in their room. There had been 7 accidents recorded in the previous 12 months. One was referred to the GP, but none required treatment. The medicines supplier had recently changed, and the home now used the blister pack dispensing system. When the MAR charts were examined, several gaps had been left without a signature. Although the majority happened on one particular shift, there were other gaps on other days. The packs were inspected and all showed that the drugs had been dispensed. The manager was disappointed that this had happened as all staff had recently undertaken a course with the new supplier. They decided to increase the quality control, and require the senior carer on each shift to check signatures. The Ashurst Version 1.10 Page 13 The Ashurst Version 1.10 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 standard(s) 22.23 The Home meets these standards. There is a complaints policy in place. The home has an appropriate policy for the prevention of abuse, and the action to take if it occurs. EVIDENCE: The Home had continued to work with a family who had been unhappy with the choice allowed to a resident. Staff were helping them understand the ability of the resident to express preferences. No other complaints had been received in the last 12 months. The Ashurst Version 1.10 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 standard(s) 24 - 30 The Home is registered for 16 places. The rooms are over 3 floors with a shaft lift. 3 rooms have en-suite facilities. There are 8 bathrooms. Most are allocated to 2 residents each. The Home was clean and hygienic except for one minor shortfall in hygiene standards with a bar of soap left in some of the bathrooms and not all of them equipped with paper towels. EVIDENCE: The new owners were undertaking a number of internal improvements. The dining room was better lit, and one of the bathrooms was being re-decorated. A new bath with an hydraulic chair had been installed in this room. All rooms had been personalised by the resident, through décor, furniture and pictures. One room had a train set on a table. 2 residents had chosen to combine their 2 rooms, using one as a sitting room, and the other for the bedroom. The Ashurst Version 1.10 Page 16 Residents were responsible for keeping their own rooms tidy. Differing levels of tidiness were seen, each being the choice of the resident. The Ashurst Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 36 CRB disclosure certificates have now been placed in personal files. New staff are also subject to the POVA search. Staff receive regular supervision sessions. 5 staff had achieved NVQ Level 2 or above, and 5 were on the Level 2 course. EVIDENCE: Personal files sampled contained the correct documentation. The newest member of staff had started after receipt of the POVA First letter, but one week before the CRB certificate had been received. The manager had drawn up a rota showing the dates of supervision sessions. Having completed the first round herself, she intends to delegate some of the sessions to senior staff. The manager confirmed that there were clear roles between herself and the registered provider who worked at the home. The Ashurst Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42,43 The change of ownership has been carried out smoothly and without detriment to the residents. The home has a history of developing the independence of its residents within a controlled risk environment. EVIDENCE: The new owners had taken over in December 2004. The person named as the registered provider worked at the home each day. The manager and the staff remained the same, so the residents had had that continuity. The provider was studying for the registered manager’s award with the intention to become the Home’s deputy manager. The manager confirmed that there was a clear separation of responsibilities between their two roles, and it was working well. Residents who spoke to the inspector appeared to exercise real choice over what they did. Risk assessments in the care plans showed how this choice had been developed through planned risk taking. The Ashurst Version 1.10 Page 19 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. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 Standard No 11 3 Standard No 31 32 33 Score 3 3 3 Page 20 The Ashurst Version 1.10 12 13 14 15 16 17 3 3 3 3 3 x 34 35 36 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 3 The Ashurst Version 1.10 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. 1. Standard 20 Regulation 17(1)(a) Sch 3 Requirement The registered person must ensure that all medicines administered are signed for immediately after administration, or the reason for nonadministration entered on the chart. Timescale for action 06/04/05 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 Good Practice Recommendations The Ashurst Version 1.10 Page 22 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich 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. Extracts may not be used or reproduced without the express permission of CSCI The Ashurst Version 1.10 Page 23 - 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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