Care Home: Ash View House

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What the care home does well The home was found clean, warm and well lit. No unpleasant odour was noted The home ensures that a comprehensive pre-admission assessment of a prospective resident is undertaken to determine if the needs of the person would be successfully met. Residents are supported and are involved in writing their care plans to ensure that it is person centred. Appropriate risk assessments are in place to enable the individuals to live as independent a life as possible. There are good relationships between the home, General Practitioner, Social Services and other health professionals. The home stated in the Annual Quality Assurance Assessment (AQAA) `residents have excellent opportunities for personal development ant access to the local community facilities in order to participate in leisure activities`.Ash View HouseDS0000072784.V374882.R01.S.docVersion 5.2Residents are also well supported to maintain good contacts with their families, friends and personal relationships. The AQAA also stated that the residents are extremely comfortable with raising concerns and complaints and are assured that they will be listened to and their views acted on. An effective staff team who are well supported by the Senior Management Team supports residents. It was evident from the staff interaction with the residents` and the records seen that there is a warm relationship between the staff and the residents at the home. What has improved since the last inspection? This is the first inspection for Ash View House. What the care home could do better: Whilst the home has a comprehensive generic risk assessment of the building and other areas that the residents have access to, it was agreed that the stairs should be included to prevent the resident, staff and visitors from falls that may lead to injury. It was also agreed that all handwritten medication on the Medicines Administration Record Sheets are signed and dated to avoid drug errors. This requirement was met before the inspection was concluded. Key inspection report CARE HOME ADULTS 18-65 Ash View House 30d Cock Road Kingswood Bristol BS15 9SH Lead Inspector Grace Agu Unannounced Inspection 7th April 2009 10:00 Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ash View House Address 30d Cock Road Kingswood Bristol BS15 9SH 0117 9602665 0117 9602665 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) Alexandra Homes (Bristol) Ltd Mr Leigh John Burleigh Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning Disability (Code LD) Mental Disorder (Code MD) The maximum number of service users who can be accommodated is 5 2. Date of last inspection New Service Brief Description of the Service: Ash View House is large detached property situated in a residential suburb of Bristol. There are local shops and bus routes in the vicinity. Since purchasing the property the provider has carried out extensive refurbishment works in order to achieve compliance with the Care Homes Regulations. The accommodation is arranged over three floors. The property comprises the following accommodation: Ground Floor – a large communal lounge, well furnished and with appropriate décor located at front of property. A further small lounge is located to the rear of the property, adjoining the dining room. First Floor – consists of three single bedrooms, one with en-suite shower, toilet and wash hand basin. A bathroom with toilet, bath, shower facility and wash hand basin is also located on this floor, for the sole use of the two other occupants on this floor. Second Floor – consists of two single bedrooms of a generous size, a shower, toilet and wash hand basin is located between the rooms for the sole use of the people accommodated in these two rooms. A further bedroom has been designated as a staff ‘sleep in room’ with en-suite shower; toilet and wash hand basin for sleep in room. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience Good quality outcomes This is the first unannounced inspection for Ash View House since it was registered by the Commission on 30 October 2008. The visit was undertaken over 8 hours to review the care provided to ensure that it is line with the legislation. The Home was operating within the required conditions of registration set down by the Commission. The conditions of registration detail the type of care and the needs of residents, and the numbers of residents who may stay at the Home. We met with the Home manager Mr Leigh Burleigh and John Duggan another manager from Alexandra Homes (Bristol) Ltd the registered provider for Ash View House. We spoke informally with two residents before they went out for the day and one resident when they returned in the afternoon before the inspection was concluded. We also had an opportunity to speak with two staff members. A tour of the building was undertaken, and a number of records were reviewed. What the service does well: The home was found clean, warm and well lit. No unpleasant odour was noted The home ensures that a comprehensive pre-admission assessment of a prospective resident is undertaken to determine if the needs of the person would be successfully met. Residents are supported and are involved in writing their care plans to ensure that it is person centred. Appropriate risk assessments are in place to enable the individuals to live as independent a life as possible. There are good relationships between the home, General Practitioner, Social Services and other health professionals. The home stated in the Annual Quality Assurance Assessment (AQAA) ‘residents have excellent opportunities for personal development ant access to the local community facilities in order to participate in leisure activities’. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 6 Residents are also well supported to maintain good contacts with their families, friends and personal relationships. The AQAA also stated that the residents are extremely comfortable with raising concerns and complaints and are assured that they will be listened to and their views acted on. An effective staff team who are well supported by the Senior Management Team supports residents. It was evident from the staff interaction with the residents’ and the records seen that there is a warm relationship between the staff and the residents at the home. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a detailed and well-planned admission process to enable prospective residents to make an informed choice about moving into the home with the assurance that their needs would be met. EVIDENCE: The home has a statement of purpose, which has detailed information about services and facilities provided at the home. This is updated on a regular baiss to reflect any changes to staffing policy and practice. These were last updated in March 2009. The Annual Quality Assurance Assessment (AQAA) stated that in addition to the information above the home has a web site which potential residents and their families can access at any time to obtain information. The home has a newsletter which is made available to potential residents/families to enable them to make an informed choice of moving to the home. The manager stated during discussion that the Social Services careplan provided them with detailed information about the two residents currently at the home and in addition, a thorough assessment was undertaken which involved visiting the residents in their various locations and spending time with Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 9 them and their families or their representatives and health professionals to enable them to ask any questions that they may have before admission. The assessment also enables the home to determine whether they can successfully meet the individuals needs. Evidence from the two care files reviewed showed that the residents were given oppotunities to visit the home and stay overnight to allow for a smooth transition from the previous envirionment and to ensure that they are comfortable with each other. We saw that each resident is provided with a contract showing the terms and conditions of their stay at the home. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individualised care plans are provided to reflect residents’ assessed needs and they are supported to participate in the running of the home. Required support with risk assessment is provided for the residents to live independent lives with the assurance that information about them will be kept confidential. EVIDENCE: We looked at the care files of the two individuals living at the home. One of the care files contained comprehensive and detailed information along with person centred care plans on how the person’s needs would be met. Other information noted in the file included, personal profile, next of kin family contacts, Doctor’s reviews and including the individual’s likes, things they would like to do and how they would like to be supported. The manager stated that this document “ A bit about me” is written with the residents’ participation. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 11 The home stated in the AQAA that within the care plans, details of behaviour which may challenge staff are documented alongside how to keep the resident safe and how to manage the behaviour. Evidence of this was noted in one individual’s care notes in relation to recent incidents. There were comprehensive and satisfactory measures in place on how staff were to support the person in the event of behavioural difficulties. The manager told us that the skill and consistent approach of the support workers had enabled the individual to overcome fear and lack of trust and that this has led to a better relationship with staff. The manager also told us that there are noticeable improvements in general and mental health of the individuals due to different approaches used to create a stable and comfortable environment for the residents. The care files seen contained individual risk assessments and were reviewed routinely and when the needs change. The manager stated that the other individual’s person centred plans are in the process of being developed by the organisation’s Counsellor, the support workers and the resident to ensure that all aspects of the individuals life is considered. Residents are encouraged to participate in the running of the home through resident’s meetings and one to one interaction and are enabled to make personal everyday choices. One resident met on the day told us that they went food shopping with the support workers. Residents are also involved in menu planning and do their own laundry and cleaning their rooms with support once a week. The AQAA stated that signed confidentiality statement about residents’ information is stored in staff files and within the residents’ contract. It is explained to the individuals about what measures are to be taken regarding their personal information. It was evident from speaking to staff that they were aware of the importance of keeping all information about the residents confidential. All residents care files were securely locked away. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 11,12,13,14,5,16,17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities for personal development and are supported to maintain links with the community, families and friends. Their individual rights are respected whilst providing healthy diets at chosen times. EVIDENCE: Information seen on the care files showed that residents are assessed and supported to participate in activities in and outside Ash View House based on their abilities and motivations. The home stated in the AQAA that there are many opportunities for personal development at Ash View House. The AQAA also stated that residents’ weekly plans are very individual and reflect their personal needs and routines. Due to the individuality of the plans, these can be altered at short notice depending on the changing needs. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 13 Evidence from one individual’s file showed that the person has a part time job on a Farm, attending three times a week, the manager told us that the home is making arrangements to increase the visit to four times a week with the individuals approval. The person told us that they enjoy working at the farm. The home would normally drop them off in the morning and pick them up later in the evening. The individual is also supported to go out for walks, cycling, bowling, cinema, shopping and also visits the parents twice a week. Risk assessments were in place to support these activities. The other individual told us that they have a full weekly programme in Swindon and that they have developed confidence to travel by train on their own. The person is involved in the Service Users Network Swindon (SUNS) and also a member of the Patients Committee. The individual made the following statement at the review of their weekly activities programme, “I do not always stick to my weekly programme as I am capable of making my own mind up on what I would like to do each day and sometimes I like to do things on the spur of the moment. I am given a choice of a lot of activities but do not always want to do them as I like going out on my own sometimes”. On the day of the visit the person went out on their own by bus to meet up with friends for coffee. They looked very happy on return, came straight into the outside office to inform the manager that they were back and that they had invited a friend over to the house one evening for dinner. The AQAA told us that Ash View House has it’s own house car and staff are drivers and are able to take residents out if required. Both individuals go on trips together and also go to Windmill farm together. In terms of educational development the manager stated that residents are given the opportunity to undertake a National Vocational Qualification (NVQ) due to the home being an approved centre for assessment. The atmosphere of the home was relaxed and calm and staff were noted to be interacting with residents in a dignified manner. The bedrooms viewed showed individual taste and choices in their personal belongings and decorations. Evidence from the visitor’s book showed that the residents are enabled and encouraged to maintain links with families and friend. One individual stated Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 14 that the parents visit regularly and the other individual has visits from mum and dad and some members of their family. We noted that the four-week menu is flexible had nutritious meals and records confirm that residents are involved in the planning of the menu. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports the residents as required and ensures that the emotional and physical health needs are met; it protects the residents from potential harm through satisfactory medication practices. EVIDENCE: Evidence from the care files reviewed and discussions with the manager show that the residents are supported with their personal and emotional care and how these are carried out. The manager was able to describe in full detail how one individual is supported routinely including the level of support provided by staff to ensure that the individual maintains independence. Evidence seen in the care files reviewed showed that the level of support given to each resident is based on individual risk assessment. This is to enable the home to provide appropriate and consistent care to both individuals. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 16 The care files also provided staff with information on actions to be taken if they were exposed to challenging situations. There was evidence in one individual’s file of how the support staff treated the person with kindness and sensitivity during challenging incidents. Entries noted in the daily report evidenced how support and personal care was provided to reflect the care plans in place. The care plans noted were regularly reviewed to include reviews from the Consultant Psychiatrist from the Community Learning Disability Team. There was evidence that residents are supported to access National Health Service facilities locally including General Practitioner Surgeries (GP), dentist, opticians, chiropodist and other relevant services. For example there was evidence in the care file in relation to how the resident with a medical condition is monitored by the GP surgery. The AQAA told us that due to the nature of the individuals’ condition, both residents receive regular supervision and treatment from a variety of health care professionals. Medication administration was reviewed and was noted to be satisfactory. Minor discrepancies noted in relation to ensuring that all handwritten medication on drug charts are signed and dated were in order to prevent drug errors were corrected on the day. There was evidence to show that staff have received training from the dispensing Pharmacy (Boots) and have also completed a training course through the National College of Further Education to ensure that they have more in-depth knowledge of medication administered to the residents at the home. There was evidence of adeath and dying policy to ensure that staff are aware of how to support individuals towards the end of life and time of death. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected from abuse and harm through robust policies, the Home provides detailed information to enable residents to complain. EVIDENCE: There were no recorded complaints seen in the complaints book since the home opened in October 2008. Evidence from the records and discussion with the manager showed that staff and residents are aware of the complaints procedure. The complaint policy and procedure is comprehensive and clearly written and has contact details of the Commission for Social Care Inspection (now Care Quality Commission) to enable the residents and or their relatives to contact the Commission if they were not satisfied with the outcome of their complaint to the organisation. This document was displayed at the entrance of the home. The document is also included in the Service Users Guide and the residents contract. The AQAA stated that the residents know who to speak to if they have any complaints or are unhappy. The individual we spoke with confirmed that they would speak to staff or the manager if they were not happy with any services provided at the home. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 18 Staff are aware of the Home’s policies and procedures in relation to reporting incidents of abuse and have received training on Protection of Vulnerable Adults from Abuse (POVA). There is also a copy of the Bristol City Council policy on POVA at the home to ensure awareness of the protocol to be followed if incidences of abuse occur. Staff met on the day confirmed that they have access to the whistle blowing policy to enable them to report any suspected abuse without fear of reprisal. Evidence from staff records showed that satisfactory references and Criminal Records Bureau disclosures were obtained for all staff working at the Home. The individuals living at the home are supported to manage their money through a bank account and the Social Services Financial Department acting as one individual’s appointee. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The relationships between staff and those living at the home are good, and this creates a warm, supportive, homely environment, which promotes a good quality of life for the individuals living at Ash View House. EVIDENCE: Ash View House is a large detached property situated in a residential suburb of Bristol. There are local shops and bus routes in the vicinity. There are two lounge areas, one that has a television and a DVD player for the residents to use. The ground floor has a large communal lounge, well furnished and with appropriate décor located at front of property. A further small lounge is located to the rear of the property, adjoining the dining room. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 20 The first floor consists of three single bedrooms, one with en-suite shower, toilet and wash hand basin. A bathroom with toilet, bath, shower facility and wash hand basin is also located on this floor, for the sole use of the two other occupants on this floor. The second floor consists of two single bedrooms of a generous size, a shower, toilet and wash hand basin is located between the rooms for the sole use of the people accommodated in these two rooms. A further bedroom has been designated as a staff ‘sleep in room’ with en-suite shower; toilet and wash hand basin for sleep in room. The residents enjoy a large/ kitchen dining area, which overlooks the patio garden, with tables and chairs which residents use often. The home is currently registered for 5 residents with learning disability and Mental Disorder however there were only 2 residents at the home on the day of the visit. The home stated in the AQAA that it plans to improve the home by purchasing a number of pictures to display in the new decorated corridors and stairwells to further enhance the homely feel. The home was found clean tidy well-lit and free from unpleasant odours. The environment was generally relaxed and very homely. The bedrooms viewed were personalised, colour coordinated, well furnished and decorated to each resident’s choice. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents enjoy a good and warm relationship with competent staff. The home’s recruitment procedures offer protection to the residents living in the home. EVIDENCE: There is a well-established skilled and experienced staff team at the home to meet the needs of the individuals living in the home. The manager told us that staff are able to demonstrate understanding and knowledge of the care needs of individual residents. Review of the rota on the day of the visit evidenced that the home had satisfactory numbers of staff competent to meet the needs of the people living in the home. Staff training records viewed and discussion with staff led us to believe staff have attended training on manual handling, fire safety, POVA First Aid appointed person and Mental Health Awareness along with basic food hygiene, Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 22 and understanding and working with Aspergers Syndrome. It was noted that each staff has their own training record. The manager stated that four staff have achieved National Vocational Qualification (NVQ) at level 3, one staff is currently registered for NVQ at level 2 and all senior staff have NVQ level 4 qualifications in Health and Social Care. Following the admission of a resident with a specialist medical condition, staff have undertakien training in relation to the condition to enable staff to support the individual. The home is an approved NVQ assessment Centre with accreditation from City and Guilds and the National College for Further Education. The manager stated that the Organisation has a resource centre in Whitehall (Bristol) where staff and residents undertake their training. It also has a rolling training programme from Bristol City Council, Boots the Chemist, St Johns Ambulance and National Autistic Society. The AQAA states that the home also uses a training package called BVS, which comes in the form of a DVD, questionnaire and assessment. Staff are expected to complete a minimum of four days of continuous professional development training in key areas of their role. Quality South West assessed the organisation in December 2008 for the ‘Investors In People’ Award. In terms of improvement in staff training, the home stated in the AQAA that any staff member receiving training would be asked to complete a self evaluation form for the training to obtain their views on the benefit and impact the training has provided them in relation to their role. The organisation has robust recruitment and employment policies and procedures in the home. Two staff records viewed contained satisfactory recruitment documentation to ensure residents are protected. Staff records viewed and discussion with the home manager evidenced that staff are receiving regular supervision to ensure that all areas in relation to thier roles and responsibilities are appropriately addressed to meet the needs of the individuals living in the home. This was achieved through planned one to one and handover meetings every Wednesday. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent leader who safeguards the interests of residents and also protects them through policies and procedures. Residents’ records are securely locked away. EVIDENCE: The Home Manager, Leigh Burliegh is competent and well qualified. Mr Burleigh has a Registered Managers Award qualification along with National Vocational Qualification (NVQ) at level 4 in Care management and NVQ Assessors award City and Guilds certificates D32, D33. The manager has 15 years experience in working with people with Learning Disabilities and Mental Disorder with Aspergers Syndrome as an area of specialty. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 24 Other training attended included all mandatory training to include POVA and First Aid appointed person’s training. Mr Burliegh is also the Health and safety officer for the home and other Alexandra Homes. Evidence noted from staff interaction with the residents and team bonding on the day of the visit showed that the home is well run by the manager. The manager demonstrated a clear undertaking of the role he has within the home and showed a comprehensive understanding of the residents’ needs. Staff spoken with appeared happy with the home’s management. Staff members we spoke with stated that the manager is approachable and would listen to any concerns staff may have. Staff work as a team, there are regular staff and resident meetings. The home stated in the AQAA that staff are aware of the systems and are able to approach the management at any time. Minutes of the senior management team meetings are circulated to staff and residents are encouraged to ask questions and approach senior management whenever they needed to. Evidence of measures used to monitor the quality of service provided at the home includes six monthly questionnaires of all staff, residents, Social Workers and family members. Post admission evaluation for the individual resident and Social worker. Training evaluation from staff and residents following recommendation from Investors in Peoples Award assessors. The home’s policies and procedures reviewed included confidentiality, Missing persons, Supervision, Protection of Vulnerable Adult and Manual Handling Death and Dying, Medication Whistle Blowing, Privacy and Dignity and Quality Assurance. These policies are reviewed regularly to ensure that staff are kept up to date in terms of information regarding how to provide continuity of care to the people living in the home. The Accident Book showed that no accident had been recorded since the home opened in October last year and the Care Quality Commission had not received any Regulation 37 Notifications in relation to any serious injuries to the residents. The fire logbook is up to date and in order. Records show that the inspection of fire fighting and fire alarms systems and fire safety training for staff has been carried out. There is evidence that staff have undertaken regular fire drills. There was evidence of generic risk assessment of various areas of the home. It was agreed that the risk assessment should include the stairs to prevent falls Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 25 to resident’s staff and visitors. Other health and safety measures including the home’s Liability insurance were in place. Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 X Version 5.2 Page 27 Ash View House DS0000072784.V374882.R01.S.doc 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 YA42 Regulation 23 Requirement Ensure that generic risk assessments include the stairs to prevent accidents to residents staff and visitors. Timescale for action 07/05/09 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 Ash View House DS0000072784.V374882.R01.S.doc Version 5.2 Page 28 Care Quality Commission South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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