Inspection on 13/08/05 for The Mountain Ash

This inspection was carried out on 13th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Mountain Ash 12/12/06

The Mountain Ash 17/01/06

The Mountain Ash 05/01/05

The Mountain Ash 10/08/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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Dovedale Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Mountain Ash Fairlight Gardens Fairlight Cove East Sussex TN35 4AY Lead Inspector Jo Mohammed Announced 13th August 2005 09:00am 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 Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Mountain Ash Address Fairlight Gardens Fairlight Cove East Sussex TN35 4AY 01424 812190 01424 814500 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) Cove Care (Mountain Ash Residential Home) Limited Mrs Julie Dignum Care Home 11 Category(ies) of Learning disability (LD), 11 registration, with number Physical disability (PD), 11 of places The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The people accommodated will be over eighteen and under sixty five years on admission 2. The maximum number of residents to be accommodated will be eleven 3. All residents will have a learning disability Date of last inspection 5 January 2005 Brief Description of the Service: The Mountain Ash is a home providing care and accommodation to eleven adults with a learning disability. The majority of service users also have a physical disability.The registered providers are Cove Care (Mountain Ash Residential Home) Ltd. The home is a converted hotel situated in the village of Fairlight. Ore, on the outskirts of Hastings, with its shops, amenities and railway station, is approximately three miles away. All accommodation is at ground floor level; bedroom accommodation consists of eleven single rooms. Communal accommodation comprises of two lounges and a dining room. Other facilities include two ‘relaxation rooms’, an indoor swimming pool and gardens. The home has two minbuses. There are currently no vacancies. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place between 9am and 2.15pm. A total of 18 standards including 16 out of the 19 key standards were inspected. Apart from one service user who was away for the weekend all the other service users were met during the inspection. A partial tour of the premises took place. Individual discussions were had with the Manager and three staff. Time was also spent examining records, observing staff and service user interactions and taking a lunchtime snack. Prior to the inspection The Commission for Social Care Inspection received feedback from six relatives via comment cards. A revised certificate of registration showing accurate details will be sent to the home following the inspection. What the service does well: What has improved since the last inspection? There was 1 requirement and 3 recommendations identified at the last inspection. Since then one requirement has been partially met. Two recommendations met and one that will be carried forward. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 6 The home has supplied a copy of the service user guide to The Commission for Social Care Inspection and to service users representatives. They have sought external training opportunities for staff with some training already having taken place and more planned. Good progress is being made to ensure that 50 of the staff team achieve a National Vocational Qualification in care at level 2 or 3 by the end of the year. 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. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 Apart from some additions that should be included in the service user guide. The home has on the whole detailed information in place to inform prospective and current service users and interested parties about the services in the home in order to make an informed decision about admission into the home. EVIDENCE: A Statement of Purpose is in place; this was examined at previous inspections. At the last inspection it was identified the service users guide be reviewed to ensure compliance. A copy of this was given and examined following the inspection. Nearly all the detail is in place apart from the following; referring to a key contract of terms and conditions, fees charged, what they cover any extra’s, service users views of the home and a copy of the most recent inspection report. It was said that a copy of the service users guide had been given to service users relatives due to the degree of disability of current service users. There has been no new service users admitted to the home since the last inspection so it was not possible to verify admission assessment practice. Key standard 2 will be inspected at future inspections should any new service users be admitted into the home. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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) 6,7,9 Good care planning systems are in place to guide staff in meeting the needs of service users. The requirement to draw up specific plans of care relating to epilepsy, insulin and review service users physiotherapy reports was positively received by the Manager. Staff showed good awareness of service users needs and endeavour to encourage as far as is possible to support service users in making decisions and choices. EVIDENCE: Individual plans of care are compiled for each service user. A selection were examined, these were found to in good order and regularly reviewed providing clear guidance to staff on how to meet service users needs. Care plans are signed by social workers on behalf of service users. Regular reviews are held, to which relatives are invited. Following discussions about service users health care needs it was required that specific care plans be drawn up to guide staff in the management of service users who have epilepsy and diabetes and the administration, management of insulin given to a service user. Also noted was that individual physiotherapy reports detailing exercises for some service users required professional review to ensure practices remain The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 10 current. The Manager reported that a Physiotherapist would be visiting the home in September and steps would be taken to have them updated at this time. Service users have complex needs and severe communication difficulties they therefore have to be assisted in making decisions. Staff have learned a variety of techniques for communicating and understanding the wishes of service users. All service users have the involvement of social workers, and all apart from one who sees an advocate have regular contact with family members. Service users are unable to manage their own monies and guidelines detailing the support service users require were drawn up during the inspection. It was said that further details to do with how much monies service users receive and appointee arrangements will be added to these guidelines. Records of income and expenditure are kept and a sample examined. These were found to be in order. Risk assessments have been undertaken on all service users. These identify areas of risk and what action should be taken to minimise them. There are also separate risk assessments in place for manual handling as the majority of service users living at the home have a physical disability. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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) 12,13,15,16,17 Service users require either full support or a great deal of support to undertake daily living activities, attend day centre activities and participate in the community. Good opportunities to achieve this are in place and good contact maintained with relatives. Staff were observed interacting in a respectful manner towards service users. EVIDENCE: Five service users attend external day care centres ranging from three to five days a week. One service user also goes to college one day a week. For service users who do not attend these centres full time or at all the home provides day care three days a week and a monthly timetable listing activities to be undertaken is displayed. Some examples of activities that take place in the home include the use of the indoor swimming pool, doing arts and crafts and using two relaxation or ‘Snoozelen’ rooms, external activities are also pursued. All service users require staff support to access the community and the home has two adapted minibuses to facilitate transportation. A range of activities are pursued for example bowling, going to places of interest, walks, shopping, The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 12 cinema, eating out and the pub. It was reported that all service users went on holiday to Butlins in June this year. It was said that service users have contact with their relatives through a combination of visits, overnight stays, visits to the home by family members and staff supporting service users to maintain contact via phone calls and correspondence. There is a daily routine for both individual service users as well as the whole group. However it was evident during the inspection that within these routines service users have freedom of movement to most areas in the home, although only three are independently mobile. During the inspection service users were seen sitting in the garden, one person was returning from a walk and later on some service users were seen relaxing in different areas of the home. The swimming pool is kept locked for safety reasons, and service users are not left on their own in the kitchen. Due to service users complex needs it was said that service users would be unable to participate in housekeeping tasks. A four-week and varied evening menu plan is in place and it was said ongoing reviews of the menu are undertaken to encompass service users likes. It was said that alternative meals are given should service users not like the meal of the day. A separate record of sandwiches served at lunchtime is kept. Special diets for two service users are facilitated by giving enrichment supplements and monitoring of a service users diet who has diabetes. Some service users are dependant on staff to eat and drink and others require some assistance and support. It was said that meals and drinks are taken in the dining room and this was found to be well presented. There was a discussion around service users only having drinks in the dining room or garden. This should be closely monitored to ensure opportunities for service users to have flexible arrangements to have drinks outside of meal times in other areas of the home are available as well. The kitchen was refurbished last year and was found to be clean and suitably equipped. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 13 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 The health care needs of service users are monitored and good contact maintained with health care professionals according to service users individual needs. EVIDENCE: The majority of service users have a physical disability and all service users are dependent on staff for help with personal care. A range of aids and manual handling equipment such as mobile hoists and overhead tracking hoists are available to assist staff in undertaking service users personal care, manual handling and transfers. A Physiotherapist has provided specialist advice and support regarding service users exercises and is due back to visit the home in September 2005. There are routines for getting service users up and going to bed and the Manager described how these are more flexible and relaxed at weekends and in the evenings. It was said that service users privacy and dignity is respected particularly when personal care is being undertaken. All service users are registered with a General Practitioner and access to a variety of other health care professionals is made according to service users individual needs. They are all supported by staff to attend appointments. There was evidence on service users files of contact and correspondence from healthcare professionals. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 Arrangements for protecting service users from abuse and managing complaints is satisfactory. EVIDENCE: A written complaints procedure is in place, the Manager was requested to add the telephone number of the Commission for Social Care Inspection to this procedure. It was reported that relatives are given a copy of the complaints procedure. A complaints log is also kept. Since the last inspection one complaint initially received by the Commission for Social Care Inspection was referred back to the home to investigate. This matter is now concluded, was unsubstantiated and seen to be appropriately investigated. A written adult protection and whistle blowing policy and procedure is in place and the Manager reported attending training in the Prevention of Vulnerable Adults [POVA]. It was said that refresher training for all staff in adult abuse was planned to take place in September and October 2005 via an external trainer. Staff spoken to showed awareness of action to take in reporting a complaint or adult abuse and were aware the home had policies and procedure in place to follow. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 Environmental standards inspected on the day were good providing service users with a comfortable and clean home to live in. EVIDENCE: A partial tour of the premises took place and areas seen were found to be well presented and maintained providing a comfortable home to service users. The garden is also well presented with a lawn and decking area. The indoor swimming pool is kept locked for safety reasons and the door alarmed. Two relaxation areas containing sensory equipment are available for service users use. All accommodation is at ground floor level. A good standard of cleanliness and hygiene was found in areas inspected on the day of the inspection. The laundry room is sited off a bathroom and it was confirmed this is not accessed when service users are having their personal care attended too. Hand-washing facilities are available and there are two sluice cycles on the washing machine. Infection control policies and procedures are available. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 16 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) 32,35. Good systems are place to ensure staff receive induction and on-going training so that service users are supported by a competent and qualified staff team. EVIDENCE: There are currently four staff who have obtained a National Vocational Qualification in care at level 3 or 4. It was reported that there are also eleven staff working towards NVQ level 2 and two towards NVQ level 3, it was said it is anticipated that all staff should complete this training by the end of this year so that the standard of at least 50 of care staff being trained at this level by the end of 2005 should be met. A range of training is provided to staff including health and safety, food hygiene, infection control, first aid and manual handling. Some of which is achieved via video training programmes and questionnaires. Identified at the last inspection was a recommendation to supplement the extensive use of video training resources with professional trainers or external courses. It was reported that steps have been taken to do this and examples given were that training in epilepsy, adult abuse, fire safety and First Aid are either done by external trainers or arrangements are being made for this to happen. It was reported and evidenced that all new staff undertake a detailed induction, which complies with required specifications. Foundation training workbooks are also available and it was said these are to be introduced and completed by staff this year. Individual staff training records are kept and these were found to be in good order. It was suggested that an overall staff training and development plan be drawn up to assist the home in keeping track of training matters. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 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) 39 The full implementation and evaluation of the home’s quality assurance monitoring systems in seeking the views of service users and other interested parties will be beneficial so that findings can be acted upon to assist the service in reviewing its performance. EVIDENCE: A quality assurance system has been introduced through the use of questionnaires sent to relatives to gather their views of the home. Identified at the last inspection was a recommendation to analyse these views, include them in the Service Users Guide and that service user questionnaires should be anonymous. The Manager reported that anonymous questionnaires for this year are to be distributed in September and the process of collating this information was discussed. It was recommended at this inspection that the views of other interested parties such as healthcare professionals and advocates also be sought. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Mountain Ash Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 19 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 1 Regulation 5 [1] Requirement Timescale for action 17th October 2005 2. 6 15 [1] Some addtions to the service users guide must be made to include reference to; a key contract of terms and conditions, fees charged, what they cover any extra’s, service users views of the home and a copy of the most recent inspection report. Care plans must be drawn up to 30th guide staff in the management of September service users who have epilepsy 2005 and diabetes including the administration and management of insulin given to a service user. 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 39 Good Practice Recommendations The views of service users, representatives, healthcare professionals and advocates should be sought, collated, analysed and included in the service users guide. The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Mountain Ash H59-H10 S21252 The Mountain Ash V230847 130805 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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