Care Home: Ashcroft Lodge

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What the care home does well The organisation is well established and found the service to have good staffing levels and well-trained staff. This enables the service to provide a high standard of consistent care. People were assisted and supported by staff to make decisions and choices about all daily living needs, this included people`s wishes and preferences. The service provided a good standard of direct personal and social care and access to health services. Care plans showed detailed individual information of peoples care needs when assessing and planning health care needs, these were found to be monitored on a regular basis. Parental contact was maintained and supported at an agreed level and in accordance to the needs of the individual person. Parents were kept informed of any issues, concerns and developments. Advocacy services were available when needed. People who use the service live in a comfortable, well-maintained and welcoming environment. The home was clean and tidy and provided a safe environment for people to live in. What has improved since the last inspection? This was the first inspection of the service. CARE HOME ADULTS 18-65 Ashcroft Lodge 18 Field Road Thorne Doncaster DN8 4AF Lead Inspector Janet McBride Key Unannounced Inspection 6 th February 2008 11:00 Ashcroft Lodge DS0000070584.V355708.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 Ashcroft Lodge DS0000070584.V355708.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. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashcroft Lodge Address 18 Field Road Thorne Doncaster DN8 4AF 01405 812 128 01405 815 209 gd@thsa.co.uk None Autism Plus Limited 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) Vacant post Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ashcroft Lodge DS0000070584.V355708.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 the following gender: Either; whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 6. New Service 2. Date of last inspection Brief Description of the Service: The organisation Autism Plus (Formally Thorne house) is a registered charity, and is run from central offices located at Fieldside Court in the centre of Thorne. The organisation recently purchased this property named Ashcroft Lodge which as been upgraded to provide care and accommodation for six younger people who have autism. Ashcroft Lodge is situated in Thorne town centre and is near a main road that links Thorne and Doncaster. The home is close to shops, railway station and is near to the M18 motorway. This house is six-bedded home in two units; unit 1 is called The Cottage, this provides care and accommodation for two people who are relatively independent and working towards semi-independent living in the future. Unit 2 called The Lodge, this is a four bedded unit for people who have complex needs and who require one to one staffing needs for their care. Both units run independently under one manager. Fees range from £1137:00 to £3500:28 as at February 2008. Fees are calculated dependent on needs e.g. 1 to 1 staffing required. The fees cover a number of items e.g. holidays, outings, skill development and various therapies. Additional charges are made for, toiletries, mobile phones, sweets and some activities e.g. bowling. For further information contact the service. The central office is at Fieldside Court is where people, families and visitors are able to access lots of information about the service and care provision, including any published inspection report. Ashcroft Lodge DS0000070584.V355708.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 star. This means the people who use this service experience good quality outcomes. Although this is a newly registered service, the organisation has been operational for some years. This was the first Key Unannounced Inspection of the service, which took place on the 6th February 2008 for six hours. The service is registered for six places. Prior to the inspection the home submitted an Annual Quality Assurance Assessment this gives information regarding the home and services provided. Pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection, documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Two care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. A tour of the premises and direct observation of staff interaction with people who use the service was carried out throughout the visit. Information was gathered from as many different individuals as possible that had contact with people within the home, including individual interviews with management of the organisation and five members of staff. We sent out surveys prior to the inspection, five were sent to people within the home who received the services, two were received back. Due to the nature of the people living at the home, it is difficult to obtain information directly from some people receiving services. Some judgements about quality of life and choices were taken from direct observations of people on the day, followed by discussion with support staff and evidencing records held at the home. The inspector concluded that people were given an good service at Ashcroft Lodge and no requirements have been made at this inspection. Four recommendations have been made in relation to the safekeeping of substances, lock on medication cupboard, re-organising of care plans and regular supervision for staff. We would like to thank all the staff and people receiving services within the home for their co-operation in the inspection process. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? 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. Ashcroft Lodge DS0000070584.V355708.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 Ashcroft Lodge DS0000070584.V355708.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): 2,3 &4. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People that use the service had information about the home and services provided. People were individually assessed prior to admission to ensure their needs would be met and supported to make informal choice. EVIDENCE: People were provided with information about the service and care they would receive in appropriate format. Surveys received confirmed that people who use the service were provided with sufficient information prior to using the services. People also said that they had many visits to the home before moving in on a permanent basis. Care plans showed that people within the service had been assessed before being placed in the home. People were introduced into the services at a slow pace taking into account background history of the person, risk assessments and a detailed plan of care that reflected any specialist interventions. The scale of charges was discussed with management and any extras that people pay for, are documented on page five of this report. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Care plans provided staff with sufficient information to meet the needs of people who use the service. People were assisted and supported by staff to make decisions and choices about all daily living needs. EVIDENCE: Two care plans were checked and discussed with key workers. People had person centred care plans that set out in detail healthcare, personal and social care needs in an individual plan of care. Care plans contained at lot of information, although the care plan was not in an organised format so the information was not available at a glance. Information was available about each person for example pen picture, limit of skills, likes and dislikes. Communication files showed the level of communication, what methods are used and what support was needed. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 10 Some people do have the input of speech and language therapy services, who advise staff with what communication methods to use for each person. This ensured that staff deliver the care required and peoples needs were identified and met. People were encouraged and supported by staff to make decisions about everyday tasks. This ensured people were consulted and had choices about daily living needs. Advocacy services were available when needed. People were supported in taking risks as part of an independent lifestyle, therefore risk assessments were in place to minimise any identified risks or hazards. These plans stated what support was needed for each individual person, and contained approaches and strategies to deal with any issues or concerns. Ensuring staff were well informed about how to support each individual to achieve their maximum potential. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 & 17. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Opportunities were provided, promoted and encouraged for the development of social and practical skills. This ensured that people had the opportunity to participate in leisure activities and live as part of the community. People were offered a wholesome and appealing balanced diet with a varied selection of food available to meet people’s tastes and choices. EVIDENCE: Staff said and records showed that people had the opportunities to develop practical life skills and social skills and make the most of their abilities. Daily routines within the home were flexible and individual, for each person who uses the service. Everyone had planned weekly activities arranged on a regular basis. People were encouraged to continue with education and development of employment skills if the individual had that potential and interest. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 12 The majority of people spent some of their time outside of the home, and had opportunities to mix with other people. For example, day care, college, swimming, shopping trips, disco’s holidays and various outings. The organisation had a fleet of vehicles to facilitate these activities and outings. Parental contact was maintained and supported at an agreed level and in accordance to the needs of the individual person. Parents were kept informed of any issues, concerns and developments. Most people go home for overnight, weekend stays or holidays on a regular basis. Staff promoted a healthy and nutritious diet, menus seen showed that most people followed a healthy eating plan. People who were capable helped prepare food and cook meals. They also went shopping with staff to buy food and help plan meals for each week. Some people had the input of a dietician and all were weighed on a monthly basis. This ensured that nutrition and weight was monitored and reviewed on a regular basis. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People’s health is monitored and arrangements for dealing with health issues were met with support from health professionals. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Care plans showed that people’s health was monitored and staff completed the OK health check, this was used for assessing and planning health care needs for each individual. People had access to health care facilities and any relevant specialists such as dentist, optician, psychology and speech and language therapist. Records clearly showed that people were assisted and support by staff to make decisions and choices about all daily living needs. Detailed information of peoples personal care needs was available, this included people’s wishes and preferences, and when staff provided personal support in daily routines. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 14 Staff were able to describe the care needs of each person, they were also aware of any restrictions on privacy, for example risks when bathing alone. Risk assessments were in place to identify any risks and how they could be managed. Records were maintained for current medication for all people within the home. Records were checked all were found satisfactory with good recording systems in place. Storage of medicines was in an appropriate locked cabinet however they are still waiting for the external cupboard to be fitted with a lock. They had a method for taking medicines to day care or when going home to stay with family. For example medicines are dispensed in blister packs in a blue wallet, which is tagged for security. Stock within the wallet is checked when the person goes out and checked back in again when they return. All stocks are recorded and signed for then re-tagged. Ashcroft Lodge DS0000070584.V355708.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 & 23. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The complaints procedure was accessible and displayed within the home. Policies and procedures were in place on adult protection, this promoted and protected people who use the service. EVIDENCE: There was a comprehensive complaints procedure, this is an appropriate format and was accessible to people. All surveys confirmed that people were aware of the complaint procedure and knew how to make a complaint. Complaint records showed no complaints had been received since the service was registered. Policies and procedures were in place regarding the protection of vulnerable adults. All staff had checks completed before being employed for example Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks. Staff confirmed they were aware of protection polices and procedures, they were able to describe the action they would take on receiving any allegations. This ensured people who use the service were safe and protected. Ashcroft Lodge DS0000070584.V355708.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, 25, 26, 27, 28 & 30. People who use the service experience Excellent outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who use the service live in a comfortable and wellmaintained environment. The home was clean and tidy and provided a safe environment for people. EVIDENCE: Accommodation within the home consists of shared communal facilities, operating as a domestic household. Each person had a single bedroom. A tour of the premises found all areas to be clean and tidy and in good decorative order with furnishings and fittings being comfortable and of a high standard. All areas looked very homely, with fresh flowers, photos and pieces of art that people living in that unit had done in art classes. Most people had visited the home and chosen their bedroom and decor before moving permanently to the home. This helped to make it more homely and provide a sense of ownership about the environment they lived in. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 17 All bedrooms were single rooms some with ensuite facilities, including medibaths (walk in baths with a seat) and showers. Bedrooms had been provided with furniture and furnishings in compliance with people’s needs and preference. Some individuals choose minimal furnishings and others had more elaborate décor this promoted their right to choose and express their own personalities. Laundry facilities are provided at the home, staff were responsible for either helping people complete this task or ensuring peoples laundry is done when required. The home had a long driveway, which was accessed by a gate, there was a large mature garden that provided a safe environment for people to use and enjoy. Ashcroft Lodge DS0000070584.V355708.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, 33, 34, 35 and 36. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Both units are staffed separately but managed by one manager, staffing was discussed with both the management and staff members. Staff that were spoken to appeared to be competent and worked positively with people to improve their quality of life. The organisation had a recruitment and selection procedures including an equal opportunities policy. All the required employment checks had been undertaken prior to staff being employed. This ensured people who use the service were safe and protected. Staff files that were checked were excellent, they were well organised and contained a front sheet checklist to ensure all required information was obtained and kept. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 19 All staff were employed on a probationary period, and received a performance review of their work and skills at three, six and nine months. Development and training records were checked and discussed with staff. Training is linked to the organisations aims and objectives of the service. Each member of staff had an individual file, these records showed what qualifications staff had achieved and when staff had completed mandatory training or refresher training. A number of staff had completed Learning Disability Award Framework (LADAF) and achieved National Vocational Qualification level 2 to 4 in care (NVQ) training. All staff said that the organisation offered excellent training opportunities. Supervision was discussed with staff, although most had received formal supervision but not on a regular basis. Ashcroft Lodge DS0000070584.V355708.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 &42. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The organisation had good policies and procedures in place to protect and safeguard people who use the service, they continue to make improvement in the provision of services to ensure effective outcomes for people. EVIDENCE: Management structure of the service was discussed with various members of the management team. The organisation has appointed a manager and his application is being processed. Unfortunely at present he his on compassionate leave, therefore day-to-day responsibility for the home continues to be the group manager. Quality monitoring within the service is done by the organisation. Internal and external questionnaires had been sent to parents and relatives to gain their Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 21 views on the care and services received, these are to be collated and published for people to read. Health and safety and safe working practice were discussed with management and some members of staff during the visit. Examination of some records indicated that all appropriate fire safety is carried out as required. Training records showed the majority of staff had received training and updates in first aid, moving and handling, health and safety and fire training. At the time of the visit all hazardous substances was not securely stored however staff moved all substances immediately to a locked cupboard within the laundry room. Ashcroft Lodge DS0000070584.V355708.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 3 4 3 5 X 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 4 25 4 26 4 27 4 28 3 29 X 30 4 STAFFING Standard No Score 31 X 32 2 33 3 34 4 35 4 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Ashcroft Lodge DS0000070584.V355708.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. 1 2 3 4 Refer to Standard YA42 YA20 YA36 YA6 Good Practice Recommendations Safe storage of all hazardous substances must be implemented. The external cupboard that holds the storage medication should be fitted with a lock. All staff should receive formal supervision on a regular basis. Care plans should be in organised format so the Information is easy to access. Ashcroft Lodge DS0000070584.V355708.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas House St Nicholas Street Newcastle NE1 1NB 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 Ashcroft Lodge DS0000070584.V355708.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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