Inspection on 17/01/06 for The Mountain Ash

This inspection was carried out on 17th January 2006.

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

The inspector 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 13/08/05

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

33 St John`s Church Road

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 Caroline Johnson Unannounced Inspection 17th January 2006 10:00 The Mountain Ash DS0000021252.V268860.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 The Mountain Ash DS0000021252.V268860.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. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Mountain Ash Address Fairlight Gardens Fairlight Cove East Sussex TN35 4AY 01424 812190 01424 814500 julie@covecare.org 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) Cove Care (Mountain Ash Residential Home) Limited Mrs Julie Dignum Care Home 11 Category(ies) of Learning disability (11), Physical disability (11) registration, with number of places The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. The maximum number of service users to be accommodated is eleven (11) Service users with a learning disability or learning and physical disability only to be accommodated 13 August 2005 Date of last inspection 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 minibuses. There are currently no vacancies. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection in the year running from April 1 2005 to March 31 2006. This report should be read in conjunction with the report of the previous inspection dated 13 August 2005. This inspection lasted from 10.00am until 3.00pm. There was an opportunity to meet with the manager, deputy manager and three members of staff. The majority of residents were seen over the course of the inspection. A number of records were examined including staff training, residents’ finances, care plans and documentation held in relation to health and safety. A full tour of the building was undertaken. Since the last inspection of the home the company has been taken over. The company name remains the same but the previous owners are no longer involved in the home. The new shareholders are part of a larger company who also own a number of other homes both in East Sussex and nationally. What the service does well: What has improved since the last inspection? As required at the last inspection the home’s service user guide has been revised. In addition care plans were drawn up to guide staff in the management of residents who have epilepsy and diabetes including the administration and management of insulin given to a resident. The staff rota has changed since the last inspection. There are now extra staff on duty two evenings a week and this ensures that there are greater opportunities for residents to go out in the evenings if they choose to. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Mountain Ash DS0000021252.V268860.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 The Mountain Ash DS0000021252.V268860.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): EVIDENCE: The manager reported that the service user guide has been updated in line with the requirement and recommendation of the previous inspection. The home has not admitted anyone to the home for a number of years so standards relating to admission procedures could not be inspected. The Mountain Ash DS0000021252.V268860.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): 6,7,9 The quality of care planning is good and could be built upon further by including in the daily notes more detailed records of the progress made in relation to achieving goals. In addition, daily notes should include reference to the choices and decisions made by the residents. All computer-generated records should be signed. EVIDENCE: Care plans and risk assessments seen generally provided detailed advice for staff to follow to ensure that the individual needs of the residents are met. The manager advised that it was anticipated that the format for care planning would be changed to bring it in line with company policy. The need to always sign computer-generated documents was highlighted and it was recommended that more emphasis be placed on improving the link between care plans and daily notes. Examples given included staff recording progress made with individual goals/needs and on recording when residents are making decisions and choices. During the inspection it was noted that residents were making decisions such as during the music session, choosing which instrument to play. One resident had decided to opt out of the music session and took himself to The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 10 one of the snoozelen rooms, where it was quiet. Another resident had chosen to spend time in the second lounge. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14, There are good arrangements in place to ensure that residents participate in a wide range of activities. Residents seen during the inspection were relaxed and obviously enjoying their music and swimming sessions. The changed staff rota should also provide increased opportunities for socialising in the evenings. EVIDENCE: As at the last inspection day care arrangements remain the same in that five residents attend external day centres and there is a detailed programme of activities in place for the six residents who remain at Mountain Ash. Staff spoken with advised that there are regular trips to the neighbouring towns of Rye, Hastings and Battle. Residents enjoy shopping, bowling, pubs and cinema and theatre. One of the residents is taken to church on Sundays. At the time of inspection there was a music session in the main lounge and two residents were using the swimming pool. The manager advised that they have recently rearranged the rota so that they can provide more outings in the evenings. The company owns two mini-buses and they are used for all The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 12 transport arrangements. Seven of the staff team can drive the minibuses. Residents enjoy and annual holiday. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 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 the following standard(s): 19,20 Staff receive training that is relevant to meeting the physical needs of the residents accommodated. In relation to residents who have limited mobility, the regular use of the pool, snoozelen rooms, relaxation chairs and standing frames all assist in ensuring good circulation, posture, comfort and prevention of pressure sores. Information needs to be included in one of the resident’s care records about the type and description of the seizures they experience. In relation to medication records, if medication has been stopped or the dose altered, information should be included on the back of the chart explaining the change. EVIDENCE: Residents’ weights are monitored regularly. Specialist advice and support is obtained when necessary to meet the individual needs of the residents accommodated. The home’s pharmacist has provided training for staff on diabetes. It was noted that since the last inspection a physiotherapist has visited the home and reviewed and updated advice regarding daily exercises carried out by one of the residents. In relation to one resident there was a detailed risk assessment in place in respect of what action to be taken should they suffer a seizure. However, there was no information provided about the type of seizures the resident experiences. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 14 All staff have had training in moving and handling. The manager and deputy manager completed a course to become trainers in manual handling in 2004. They hope to update this training so that they can continue to provide training for their staff team. Some of the residents have very limited mobility so their position is changed regularly throughout the day. Medication is stored in a monitored dosage system and the cupboard is kept secure. Records are kept of all medication administered to residents and if `as required’ medication is administered to a resident the reason it was given is recorded on the back of the MAR (medication administration record) chart. Where medication is no longer in use or the dosage has changed this should also be recorded on the back of the MAR chart along with the reason and the date. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 15 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): 23 There are clear and detailed arrangements in place for the management of residents’ finances. EVIDENCE: The manager advised that there had been no complaints since the last inspection of the home. Residents’ finances were discussed in detail and records held in relation to two residents’ finances were examined. Individual bankbooks clearly showed all incoming monies and the home kept detailed records of all expenditure. Receipts are kept for all purchases. All staff have had training in adult protection and prevention of abuse. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 16 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): 24,25,26,27,29,30 Accommodation provided is spacious. Furniture and fittings look homely and domestic in design. There are a variety of communal areas, which means that several different activities can be carried on at the same time. The swimming pool is a valuable resource and the residents benefit individually from regular access. EVIDENCE: Communal areas include a large lounge/dining room. In addition there is a second lounge and two snoozelen rooms. In the main lounge there is a television and music centre. Some of the residents have their own specialist relaxation chairs in the lounge. In the second lounge there is a piano and a music system. One of the staff spoken with stated that this lounge is often used by residents who enjoy quietness and if they want to be on their own. There is a large garden to the rear of the building including a large decked area. There is also an indoor swimming pool on site with hoist facilities and specialist changing areas. The swimming pool is available for hire by the wider community, outside of the times used by the residents of the home. Each of the residents has their own bedroom and all rooms are spacious and have ensuite facilities. Residents have varying degrees of physical disabilities and there is a wide range of specialist equipment in place to meet their The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 17 individual needs. All areas of the home seen were clean and there were no unpleasant odours. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 18 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): 32,33,35,36 Staff are well supported and receive regular supervision. There are good training opportunities available to staff and the low staff turnover means that the staff team have become skilled and competent in meeting the needs of the residents accommodated. EVIDENCE: The manager advised that there are generally six care staff on duty, not including the manager, through the day. On occasions levels are increased so that specific activities can take place and at weekends if a resident goes home staff levels can go down to five but never below five. At the time of inspection there was one vacancy for a night worker three nights a week and the position had been advertised. The manager reported that home does not use bank or agency staff. If there are vacancies or sickness then part-time staff work overtime. It is company policy to wait until a CRB (criminal bureau check) is obtained prior to new staff starting to work in the home. Two staff members have completed NVQ level three and another two staff level four. Another eleven staff have almost completed NVQ level two and two are doing level three. The manager advised that the new company were keen to continue investing in staff training. A training matrix showed that all staff had received core training in 2005 and arrangements were being made for all staff to attend The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 19 further courses during 2006. Staff have also had training on adult protection, epilepsy and diabetes. Records showed that all staff receive regular supervision. The staff team is divided into groups and members of the senior team take on the responsibility for supervising staff in their group. A senior staff member stated that the new company would be introducing a new format for carrying out supervision. A staff member spoken with stated that she enjoyed her regular supervision sessions and that her senior was very `supportive’. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 20 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): 37,38,42,43 The home is run well and the manager is continually looking at ways of updating her knowledge and skills, which in turn is of benefit to the home. There are detailed arrangements in place to ensure the health, safety and welfare of residents and staff. It is still very early days in terms of the new external management arrangements but the staff team were cautiously optimistic. EVIDENCE: The manager has completed the Advanced Management in Care, which she confirmed is equivalent to NVQ level four. She is currently doing the Assessor’s Award. She and the deputy manger have booked to attend a number of courses during the coming year including: - time management, assertiveness, managing relationships, recruiting, managing change and developing care plans. Staff spoken with stated that they were `well supported’ and that if they had a problem they would be able to speak with either the manager or deputy The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 21 manager. Staff meetings are held once a month and team leader meetings are also held monthly. There is a detailed health and safety risk assessment of the building in place. Records showed that all equipment in the home is serviced at regular intervals and there was a wide range of certificates confirming this. In December 2005 the company was taken over. The company name remains the same but the previous owners are no longer involved in the home. The new shareholders are part of a larger company who also own a number of other homes both in East Sussex and nationally. The manager reported that external support systems were good. She had met with the Responsible Individual and the area manager had visited to carry out a report on the conduct of the home. She had also attended a manager’s meeting and advised that this would be a useful resource in the future. She stated that there was always someone available to contact by telephone if there was a problem. She had yet to have a formal supervision but was anticipating that supervision would be provided on a regular basis. She had been advised that company policies and procedures would be introduced but assurance had been given that she would have autonomy to include policies and procedures that are applicable and specific to Mountain Ash. Staff spoken with advised that the take over had been very smooth and so far had little impact on the day-to-day running of the home. They anticipated that changes would happen in the coming months and were `cautiously optimistic’. The one area they were worried about was the future of the swimming pool. Staff were unanimous that the pool is an excellent resource for the residents and that they all benefit significantly from regular use of the pool. The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 22 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Mountain Ash Score X 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 3 DS0000021252.V268860.R01.S.doc Version 5.0 Page 23 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 YA6 Good Practice Recommendations Daily records should be used to record progress made with goals in care plans. They should also be used to record examples of the choices and decisions made by individual residents. All computer-generated documentation should be signed. In relation to one resident, information should be included in their care plan about the type and description of the seizures they experience so that new care staff would know what to expect should they see a seizure for the first time. In relation to medication records, if medication has been stopped or the dose altered, information should be included on the back of the MAR (medication administration record) chart explaining the change. 2. YA19 3. YA20 The Mountain Ash DS0000021252.V268860.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office 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. 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