Care Home: Ashbrook House

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What the care home does well The homes AQAA considers that peoples views are important to the running of the home. Regular `resident and keyworker meetings` are held. When people are unable to attend residents meetings, key workers make sure that individuals `are asked a series of questions and are invited to air any concerns or ideas to improve the service.` Each person who lives in the home has a designated advocate. All eight surveys completed by people that live in the home indicated that staff treat them well and they are able to make decision about what they want to do each day. One person commented `Staff respect me and do what I ask for.` One member of staff considers: `Here in our home, our colleagues are very supportive and are looking forward to help our service users in their daily needs. I wish that all the homes around UK can do their best as well for their full support towards all service users.` We consider the consistent approach by all the staff team and the focus on putting the person at the centre of care enables people who chose to live there to develop independent living skills and lead fulfilling lives. What has improved since the last inspection? Requirements and recommendations made at the previous Key Inspection in 2006 have been met. No issues were identified in the Annual Service Review undertaken in October 2007. CARE HOME ADULTS 18-65 Ashbrook House 20 St Hellier Avenue Morden Surrey SM4 6LF Lead Inspector Janet Pitt Key Unannounced Inspection 17th September 2008 11:15 Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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 Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbrook House Address 20 St Hellier Avenue Morden Surrey SM4 6LF 0208 646 3096 F/P 0208 646 3096 dfhjsg4654@aol.com 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) Ashbrook House Limited Manager post vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Ashbrook House DS0000027206.V371830.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 - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 9 13th July 2006 Date of last inspection Brief Description of the Service: Ashbrook House is owned and managed by Allied Care, a private organisation. The home is situated on a busy road in Morden close to local shopping, entertainment and public transport amenities. The home opened in 1999 and provides care and accommodation for up to nine residents with learning disabilities, some of whom also have physical disabilities. The home is staffed twenty-four hours a day with staff awake in the home throughout the night. Allied Care own a significant number of care homes across the South East of England. Fees for this home are on average £1229.68 per week dependant on care needs. Ashbrook House DS0000027206.V371830.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 three stars. This means the people who use this service experience excellent quality outcomes. One inspector undertook this unannounced inspection. Two site visits were made that lasted in total four hours. During this time we spoke with people who live in the home, members of staff and a relative of someone who had recently moved in. Surveys from individuals and staff were received and comments from these have been included in this report. Observations were made of staff interactions and the general everyday business of the home. Records relating to staff recruitment and care planning were inspected. The manager completed an Annual Quality Assurance Assessment (AQAA). This has also been used to inform this report. What the service does well: What has improved since the last inspection? Requirements and recommendations made at the previous Key Inspection in 2006 have been met. No issues were identified in the Annual Service Review undertaken in October 2007. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Ashbrook House DS0000027206.V371830.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 Ashbrook House DS0000027206.V371830.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who chose to live in Ashbrook House can be confident that their needs will be assessed fully prior to them moving in. Opportunities are available for a person to visit the home and meet others who live there. EVIDENCE: Only one person has moved into the home since the previous inspection. Examination on care records showed that an assessment was carried out by the home prior to admission. People are involved in this process and where there have been communication needs then the next of kin or an advocate have represented the individual. We noted that there was good information on any independent living skills a person has and how these would be included in their day, e.g. assisting with housework. We found that a person’s named social worker had provided a report that had been incorporated into the initial assessment. One relative spoken with said that they had been able to visit the home and meet other people and staff prior to a decision being made about moving in. Surveys received also confirmed this: ‘[their] mum and dad brought [them] Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 9 and [they] loved it and up to now.’ and ‘[The person] spent three hours here to look around.’ Ashbrook House DS0000027206.V371830.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 People who use this service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are involved in the process of care planning. Care plans are person centred and reflect the needs of the individual. Individualised support by staff is given consistently to people who live in the home. Suitable risk assessments are in place that do not impact on individuals rights. EVIDENCE: We noted that care plans lead from assessments and included appropriate risk taking. The person or their representative is involved in the process and it was clear that their views were listened to and acted upon. For example communication needs of people had been documented and any specific nonverbal clues that would indicate their mood had been indicated. Support plans had been written from the person’s viewpoint. Care plans had been routinely reviewed and any changes had been agreed. If necessary there was detailed guidance in place for staff to refer to, such as Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 11 behavioural triggers and actions to take or information on a condition such as epilepsy. Individuals spoken with at the site visits were ‘happy’ with the support they received and we observed that staff made sure that individuals were able to make decisions. For example some people had gone with staff to do the food shopping and one person wanted to delay their lunch, as they were busy with another activity. Risk assessments were personalised and gave detailed instructions on how to manage risk, such as vulnerability to other people when accessing the community and risks in the home presented by items like sharp objects. Ashbrook House DS0000027206.V371830.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): 12, 13, 15, 16 and 17 People who use this service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are able to maintain and develop new hobbies and interests. Their choices on relationships are respected and individuals are able to keep in contact with their friends and family if they wish. Mealtimes are a sociable occasion and the menu is planned in conjunction with the people that live in the home. EVIDENCE: All people that live in the home have their own individual activity plan. Activities include attending day centres, aromatherapy, reading, pottery, music, cinema, bowling, swimming and walks. Opportunities for attending places of worship are also available. We observed that each person was able to make individual choices about what they did and when. One person spoke of the various groups they attended with enthusiasm. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 13 We spoke with staff about people being able to maintain or develop personal relationships and they said that people are able to invite friends over to stay if they wished or join them in a meal. Friends and family are able to visit when they wish; a relative who visited the home confirmed this. Some people chose to go and visit their families and friends at weekends and for holidays. The home has a minibus that is used for visits to places like Richmond Park and the local shops. We observed the lunchtime meal; this was seen to be unhurried. One person laid the table ready for meal. Each person was able to sit in their preferred seat. Staff gently encouraged the person laying the table to complete the task. The meal served was hot and looked and smelt good. Portion sizes were sufficient. Fresh fruit was available and one person helped themselves to a piece of fruit before lunch. Individuals’ food likes and dislikes were seen to be recorded on admission. Holidays have been taken in Hastings and Blackpool this year. The manager said that one person is planning a trip to Disneyland next year. The company pays for staff to go on holiday with people that live in the home. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Support plans detail how all needs will be met. Links with other health professionals are maintained and advice is sought when needed. EVIDENCE: We spoke with people on the site visits, who confirmed that they were supported with personal care. Their support plans contained detailed information on how they would like care to be delivered. There was evidence of interventions by other health professionals if needed, such as the general practitioner. No issues with medications have been reported to us since the previous inspection and annual service review, therefore on the information we hold we consider that there are no issues with the handling of medications. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open complaints procedure that enables people’s views to be heard. Any concerns raised are listened to an acted upon. Individuals can be confident that they are protected from harm by staff awareness and the procedures within the home. EVIDENCE: Each person has an accessible copy of the complaints procedure within the home. Survey respondents indicated that they knew who to raise any concerns with. Comments included “[they would] tell the keyworker and the manager.” The AQAA indicates that there has been one complaint that was not upheld. There have been no Safeguarding Adults investigations. The home thinks that it has improved staff understanding of Safeguarding Adults, by making sure that they have received training and are aware of the ‘Whistle Blowing Policy.’ A copy of the local authority’s Safeguarding Procedure is available at the home. The AQAA states that records of people’s personal financial transactions have been reviewed and regular checks and audits are carried out to make sure that there are no irregularities with handling of money. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in Ashbrook House are able to choose the décor and furnishings of their bedrooms. Independent living skills are maintained and developed by involving people in the domestic duties. EVIDENCE: Ashbrook House provides a domestic style accommodation for the people that live there. The home and staff are welcoming and was found to be clean and tidy on the days of the site visits. We spoke with some members of staff who said that when rooms are redecorated people that live in the home are able to choose décor schemes. This was evident in the variety of colours and fabrics in different rooms that we viewed. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 17 Household tasks are part of the agreement between the home and people who chose to live there. This makes sure that people develop and maintain independent living skills. Information on the AQAA evidences that all staff have received training in food handling. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use this service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are support by a stable staff team who are proactive in making sure that needs are met according to a person’s wishes. Training is targeted to staff needs to make sure that they have the necessary skills to carry out their role. Staff are supervised appropriately and recruitment procedures make sure that individuals are not placed at risk of harm. EVIDENCE: The homes AQAA indicates that staff are recruited in a safe manner with necessary checks and references being taken up, prior to a person commencing employment. This was confirmed when we examined staff files. There was evidence of good recruitment practice; interview records were on file and a full employment history was detailed. Supervision of staff is planned and carried out regularly. Each member of staff has a supervision contract and there were individual records of sessions held. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 19 Staff surveys verified that they receive suitable induction and ongoing training. One comment: ‘the company have training ongoing throughout the whole year which are relevant to the type of job which we are doing.’ There is a training matrix available that shows when mandatory training, such as first aid, is due. This enables the home to plan training sessions throughout the year. The AQAA states that an area for improvement in the next twelve months is: ‘to use [the] system which would provide accurate information of who has attended training and to ensure that evaluation sheets are completed by staff who have received training to develop quality.’ Some staff surveys commented on the involvement of the local community nurse who visits the home on a monthly basis and assists in helping the staff develop support plans with a focus on a person’s particular needs due to learning disabilities. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Ashbrook House has a manager who is proactive in making sure that standards are met and maintained. Improvement has been made in making sure that the views of the people who live in the home are heard and acted upon. EVIDENCE: People who live in the home are supported by a manger that has the skills and experience necessary to manage the staff team and focus on people’s requirements. The manager showed us evidence of her Registered Managers Award and informed us that she is in the process of registering with CSCI. Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 21 The information contained in the AQAA was noted to be detailed and included plans for how the service hopes to develop over the next twelve months. We spoke with the person from the company who is responsible for quality audits and she said that she has always been made welcome in the home and enjoys her visits there. Comments from staff surveys included: ‘All staff work as a team.’ and ‘We receive full support from our manager in case of any help needed.’ Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 X 3 X X 3 X Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ashbrook House DS0000027206.V371830.R01.S.doc Version 5.2 Page 25 - 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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