Care Home: Ashley Close 1 & 2

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What the care home does well The home support residents through a comprehensive and detailed care plan for each resident to ensure that their identified needs were being met. Care plans are `person centred` and reviewed on a regular basis to address the changing needs of individuals who have complex health and social care needs. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. The staff team including management continue to demonstrate their openness in the day to day running of the care home. The environment is well maintained and both Bungalows have a good standard of cleanliness that was evident throughout those areas viewed. The systems in operation including complaint and safeguarding adults should offer adequate protection to people using the service. What has improved since the last inspection? The requirement and recommendations made in the last inspection were addressed. All hazardous substances are securely kept locked at all times in line with COSHH regulations. Safe infection control practices are maintained and the hot water is checked on a regular basis. What the care home could do better: The home should ensure that repair works are carried out in a timely manner. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashley Close 1 & 2 1 & 2 Ashley Close Bennetts End Hemel Hempstead Hertfordshire HP3 8EH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Farrier     Date: 1 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Ashley Close 1 & 2 1 & 2 Ashley Close Bennetts End Hemel Hempstead Hertfordshire HP3 8EH 01442258226 01442258226 Ashleyclse2@walsingham.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Walsingham care home 12 Number of places (if applicable): Under 65 Over 65 12 9 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home 12 9 Ashley Close was previously registered as two separate homes, both of which opened and first registered in 1996. In 2006 the two homes joined together and they are now managed as one home. Ashley Close provides personal care and accommodation for twelve people with learning disabilities. It is owned and operated by the voluntary organisation Walsingham. The home is part of a modern development in a very quiet cul-de-sac in a residential area in the Bennetts End district of Hemel Hempstead, close to local shops and amenities and two day centres. Each house has six single bedrooms for service users, in domestic style accommodation and suitable equipment to meet any special needs. The houses and gardens are fully accessible for the current residents. Staffing is provided twenty four hours per day. The Statement of Purpose and Service Users Guide provide information about the Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home home for referring professionals and prospective clients. These and the most recent inspection report are available on request. The current charges range from £ 1,403.59 to 1,119.97 per week. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 12th June 2009 and took one day. It included talking to staff, examining care plans, staff files, staff training records, fire safety procedures, medicine records, maintenance records, all other records and documents and a tour of the premises. We looked at all the information we have asked for or received about the home, since the last inspection. This information included the Annual Quality Assurance Assessment (AQAA), sent by and returned to the Commission from the homes manager. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also provides some statistical information about the service.The information provided in the AQAA was also checked against the findings as set out in Care Homes for Adults (18-65 years) Page 6 of 27 the last inspection report. What the care home does well: 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 set out 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. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be assured that an assessment of needs would be carried out before an offer of placement is made. Evidence: Adequate information about the home including a copy of the Statement of Purpose and Service Users Guide was available to current and prospective residents. Care plans examined showed that an assessment of individuals needs was carried out prior to moving in. This process involves the input of the prospective resident, their family and other professionals. The home has policies and procedures in place for ensuring that the needs of individuals moving in can be met. This would include the opportunity to meet the other residents and try out the service. As stated in the AQAA, the registered manager will with the next twelve months ensure that Personal Planning for each resident is reviewed regularly and their needs Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: are met appropriately. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their identified needs would be met and that they would be enabled to live the lifestyle they choose. Evidence: Each person has a person centred plan of care based on their views about how they wish to be supported from day to day and longer term goals. These are reviewed on a regular basis and any changes are reflected within the support plan. Each care plan includes the assessment of needs, various risk assessments, goal and action plan, the residents profile, communication folder with photographs, information about support provided, keyworker system, personal care plan (dressing, mobility, sleeping patterns, behaviour, health problems, continence, personal safety) day care programme and a health care plan. Daily records are kept in a form of a diary for each individual. Family, advocates and professionals from specialist services are also involved in the assessment process and reviews. The support plans reviewed demonstrated that Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: individual procedures are in place for situations that require staff to promote positive behaviour and independence in challenging situations. As stated in the AQAA, the registered manager will within the next twelve months ensure that all staff are trained in communicating with residents who have complex needs. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported to live full and active lifestyes. Evidence: Each resident has an activity programme and most of them attend a day centre. Staff support each resident to take part in activities of their choice either individually or in groups. On the day of the inspection all residents from Bungalow 1 were out on a community trip. Daily activities are recorded in the care plan as goals. Staff spoken to said that they repected individuals privacy and supported residents to be as independent as possible. The menus were planned in consultation with the people in the home and a well balanced, nutritious diet is provided. Care Homes for Adults (18-65 years) Page 14 of 27 Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to express their individual personalities through the choices they make. They are able to access local community health services to maintain and promote a healthy lifestyle Evidence: Care plans examined showed that residents identified needs were being met and that all residents are registered with a G.P. Individuals receive personal and healthcare support using the Health Action Plan that was reviewed and kept up to date at each health appointment attended. Staff spoken to said that the support provided for residents was based upon identified needs including the rights of dignity, privacy, choices and respect. Overall, there are good systems in place for ordering, storing and administering the medication that the each resident requires. The systems meet the required standards and were found to be satisfactory on the day of inspection. Advice and guidance was given on healthy options and preferences. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: As stated in the AQAA, the registered manager will within the next twelve months review current guidelines and residents care plans. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their concerns would be listened to, and that they are safeguarded from risks of abuse. Evidence: A copy of the complaints procedure is available to residents and their faminlies. A simplified version has been produced using pictures and symbols designed to be easier for residents to understand. One complaint has been received from a member of staff and this was being investigated by the care home. The home has policies concerning Safeguarding Adults that follow the Hertfordshire County Council inter- agency guidelines and a copy of the Safegurading Adults procedure was kept in the office. Staff spoken to confirmed that they had training in safeguarding adults. This subject is also discussed in staff induction programme. staff also confirmed that they were aware of the general principles involved incluiding the companys Whistle Blowing Policy. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported in an environment that is homely and comfortable Evidence: The home consists of two purpose built bungalows, situated in a cul-de-sac in a residential area of Hemel Hempstead. Both bungalows are furnished and decorated in domestic styles that is homely and comfortable environment for residents to live in. Each resident has their own bedrooms, arranged and decorated to reflect their paricular interets and tastes. The lounges, dining rooms and kitchens are domestic in style. Each bungalow has an enclosed garden with a patio area, lawn and flowerbeds. The home was kept clean, fresh and generally well maintained. However, it was noted that in Bungalow (2) taps in residents bedrooms were leaking and one has a broken cupboard door. These should be repaired and maintained in good working order to complement the well maintained environment of the care home. Staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. As stated in the AQAA, the registered manager will within the next twelve months replace some of the carpeting. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policy and practices. Evidence: Adequate level of staff was rostered to meet the needs of residents. Staff files were not available for inspection as these are kept at the head office. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the residents. Staff spoken with indicated that they have opportunities for relevant training and this gives them greater confidence to do their jobs. Staff were very knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, there are 26 care staff employed, 15 of whom have completed the NVQ Level 2, 4 has completed Level 3 and 3 are undertaking this training.2 staff ahve completed the NVQ Level 4. Staff spoken to confirmed that they received one to one formal supervision on a regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: approachable and available for advice as and when needed. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health, safety and welfare are protected by policies and procedures and a managed care home. Evidence: The management communicate a clear sense of leadership within the home and have an open-door policy where staff could see them at any time with any issues or concerns they may have. The implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in an manner that benefits people using the service and the staff team. The home has a quality assurance system in place and seek the views of people using the service, relatives, staff and other interested parties. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. The Commission has been kept informed of all accidents and admissions to hospital. A valid Employers Liability insurance certificate was displayed and expires on the 31st March 2010. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 Bungalow (2) taps in two of the residents bedrooms were leaking and one had a cupboard door broken. These should be repaired to complement the environment of the care home. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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