Care Home: Ashness Two

Similar services:

• Townley Road, 2-3
• Foxley Lane (121a)
• Tudor Lodge
• Stacey Street Nursing Home
• Delrose House Ltd
• Clovelly House Residential Home Ltd
• Abbey Road [53]
• Cherry Tree House

What the care home does well `They really treat you nice here` one resident observed. Feedback from all residents spoken to was very positive about their experiences of living at the home. The home has a homely and relaxed atmosphere and is kept clean and tidy. The standards of decoration and furnishings within the home are very high. Members of staff have got to know the residents very well and understand their individual needs and preferences. As a result residents are able to communicate confidently with staff. There is a skilled, committed and generally experienced team of staff at Ashness Two who work well together. Staff feel well supported by the management team at the home. The staff team has also had a significant amount of training in working with adults with mental health needs, including those with challenging behaviours. Consequently the residents get the benefit of living in a home where they feel understood and supported. Each person is seen and treated as an individual in their own right. This approach gives people the opportunity to build and develop for themselves more positive lifestyles than they have had previously. In most cases residents have been through a number of living situations that have not been able to meet their needs. They are now benefiting from being well supported by staff so that in general their mental heath is stabilising and their level of challenging behaviours is reducing. There is a strong emphasis on promoting independence for people living at the home including encouragement to self cater, carry out housework, use bicycles provided by the home etc. as a first step in preparing to move on into more independent settings in the future. The home is in close proximity to another similar but longer established home run by the provider organisation, and staff are therefore able to support one another across the homes, as appropriate. What has improved since the last inspection? Not applicable as this is the first CSCI inspection of this home. CARE HOME ADULTS 18-65 Ashness Two 41 Cranleigh Road Haringey London N15 3AB Lead Inspector Susan Shamash Unannounced Inspection 16th – 20th May 2008 1:15 Ashness Two DS0000071324.V364167.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 Ashness Two DS0000071324.V364167.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. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashness Two Address 41 Cranleigh Road Haringey London N15 3AB 020 8809 9958 020 8361 5573 nicholas.purchase@btopenworld.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) Ashness Care Ltd Amos Boyede Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories 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: 2. Mental Disorder, excluding learning disabilities or dementia - Code MD The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief Description of the Service: Ashness Two is a small care home for four adults with mental health needs who may have forensic histories. It is run by Ashness Care Ltd. which owns another home for people with mental health needs in the area. Ashness Two opened in December 2007. The home is situated in a residential road near Green Lanes and West Green Road in Haringey. It is close to shops and public transport networks. Each resident has their own bedroom with en-suite facilities. Residents share a lounge, dining room, kitchen area and garden area. The home’s brochures states the aim of the service is: ‘To provide a service for people with long and enduring mental health needs’ and ‘To build therapeutic relationships and work together with individual residents to enhance their quality of life and achieve their optimum level of independent living.’ In May 2008 the weekly fees charged are between £1050 to £1250. Copies of the most recent CSCI inspection reports are available from the home’s office. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place primarily over one day lasting approximately eight hours. I was able to follow up on some information not available at the time of the inspection but provided a few days after the visit. The registered provider and the registered manager assisted throughout the inspection. I spoke to three of the four residents living in the home during the inspection. People living at the home are very able to communicate how they feel about living at the home and were overwhelmingly positive about their experiences. I observed the way in which staff communicated with and supported residents and interviewed one staff member. A variety of records, including care plans, staff files and health & safety documents were looked at, alongside information provided in the Annual Quality Assurance Assessment for the home. What the service does well: ‘They really treat you nice here’ one resident observed. Feedback from all residents spoken to was very positive about their experiences of living at the home. The home has a homely and relaxed atmosphere and is kept clean and tidy. The standards of decoration and furnishings within the home are very high. Members of staff have got to know the residents very well and understand their individual needs and preferences. As a result residents are able to communicate confidently with staff. There is a skilled, committed and generally experienced team of staff at Ashness Two who work well together. Staff feel well supported by the management team at the home. The staff team has also had a significant amount of training in working with adults with mental health needs, including those with challenging behaviours. Consequently the residents get the benefit of living in a home where they feel understood and supported. Each person is seen and treated as an individual in their own right. This approach gives people the opportunity to build and develop for themselves more positive lifestyles than they have had previously. In most cases residents have been through a number of living situations that have not been able to meet their needs. They are now benefiting from being well supported by staff so that in general their mental heath is stabilising and their level of challenging behaviours is reducing. There is a strong emphasis on promoting independence for people living at the home including encouragement to self cater, carry out housework, use bicycles Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 6 provided by the home etc. as a first step in preparing to move on into more independent settings in the future. The home is in close proximity to another similar but longer established home run by the provider organisation, and staff are therefore able to support one another across the homes, as appropriate. 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. Ashness Two DS0000071324.V364167.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 Ashness Two DS0000071324.V364167.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): 1, 2 and 4. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from living in a home that is able to meet their needs as detailed assessments are made prior to their staying at the home. They are provided with sufficient information about the home and have the opportunity to visit and stay at the home in order to make an informed decision whether to move in on a permanent basis. EVIDENCE: ‘I’ve been in so many other places, but they really treat you nice here’ one resident told me. Other residents spoken to said that they enjoyed living at the home, were happy with the environment and had all facilities that they needed. All confirmed that they had visited and been given the home’s brochure prior to moving in, as well as having an opportunity to test-drive the home and being involved in their assessments. The files for two of the four people living at the home were looked at in detail and indicated that before they moved in a full mental health assessment had been received by the home. Care plans had then been drawn up by the home showing how the resident’s needs were to be met. The home’s own assessments and those of mental health professionals indicated that residents are appropriately placed and their needs are being met. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 9 Observation during the inspection, together with the care plans, indicated that residents are appropriately placed. Staff and management advised that the home is careful to ensure that it is able to meet the needs of new residents and does not admit people whose needs it is unable to meet. Information provided in the Annual Quality Assurance Assessment for the home also confirmed that carefully consideration is given to people’s past history (in discussion with the multi-professional team), abilities and interactions with other residents. The manager and provider had formats of terms and conditions available for residents to sign, and advised that these would be completed at residents’ first multi-disciplinary review meetings at the home. Ashness Two DS0000071324.V364167.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 the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed information on how people’s needs are met at the home so that residents feel that they are well supported. People living at the home are given the opportunity to make lifestyle decisions for themselves and gain independence skills. Residents’ safety is protected by risk assessments that indicate how these risks will be reduced although they might benefit from further consideration of more general risk areas. EVIDENCE: Feedback from the three residents interviewed was very positive about how they were supported at Ashness Two. Residents thought their needs were being met and that they were getting on well with each other. Discussion with staff and management indicated that they were very aware of each resident’s support needs, including how each person was getting along with other people living at the home. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 11 The records for two residents were looked at in detail and indicated that each had a current plan of care. These set out the needs and goals of the resident and how they are to be met by the home. These plans include reference to the lifestyle choices of each resident including religious and cultural needs. Throughout the inspection, I observed that people living at the home were facilitated to make their own choices about how they spent their day, when and what they ate, when they got up or went out etc. Where residents have restrictions on their choices under the Mental Health Act this is stated in their care plan alongside risk assessments. All care plans recognise potential risks to residents and the risks that they may pose to others due to mental health problems or behavioural issues. The plans outline how these risks can be minimised, for example detailing action to be taken by staff if a resident becomes agitated or violent within the home. The risk assessments also highlight what things might anger or agitate a particular person and how these can be avoided or managed. As a result residents feel more relaxed and settled in the home with few incidents of challenging behaviour. Staff and management interviews indicated that members of staff understand how to support residents. They do this in line with training they have had on how best to manage the challenging behaviours and unpredictable mental health issues presented by residents. My observations indicated that the home achieves highly in the area of enabling people with complex needs to manage well in a small group living situation. Risk assessments are monitored and reviewed regularly, but do not always include non-mental health or behavioural risks e.g. financial vulnerability, road safety (for a resident using a bicycle) etc. It is therefore recommended that more general risk assessments be recorded for people living at the home, to ensure that they are protected from harm in all relevant areas. It is appreciated that as a new home, care plans are still being developed for people who have moved into the home. However it is recommended that in time, more detail be included within people’s care plans, and with regard to recording progress made to reach goals, so that these are more personalised to the needs of each person. Ashness Two DS0000071324.V364167.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, 14, 15, 16 and 17. People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have a good quality of life with encouragement to take part in a range of stimulating activities. They are supported to be part of their local community and receive visitors from friends and family so that they feel less isolated. Residents benefit by having staff who allow them to make choices for themselves so that they have as much control over their lives as possible. They have a choice about what they eat and are encouraged to develop independence skills within the home. EVIDENCE: Two people that I spoke to told me about a range of day activities, including drop ins and day centres that they attended regularly. All advised that they did not wish to take a college course but were looking to increase their skills so that they might find employment in the future. One person told me that their future aim was to work for the council or find employment in painting and Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 13 decorating. A resident with particular ethnic and cultural needs told me that they chose to attend a local centre regularly which reflected their cultural needs. Discussion with staff and residents confirmed that residents make their own choices about what they wish to do and when. Resident’s daily logs included records of activities offered to or taken up by residents. One resident told me that they enjoyed listening to a local cultural radio station. Observation and feedback from residents and staff showed that residents get out and about in their local community, including going shopping, using the local leisure centre, cycling, to local parks etc. Residents generally use public transport to get out and about. The manager advised that staff have worked hard at cultivating good relationships with neighbours, and work with residents to ensure that they are supported to limit any anti-social behaviours. Other leisure activities recorded for residents included trips to the local pub, a Party in the Park event, meals out and a barbeque held at the home. Staff and residents advised that a trip to the coast was being planned in the next few days, alongside more trips to the pub and a cinema trip. One resident told me ‘talking to the staff is like opening a newspaper’ telling me that they were very helpful and always provided useful information about residents’ rights and facilities available in the local area. Residents told me that they can invite friends and family members into the home if they wish to, although there are clear conditions about this. The management advised me that restrictions had been placed on one particular visitor due to concerns over the exploitation of a resident. I spoke to the resident concerned and they were satisfied with this restriction. Clear guidelines are in place regarding residents having partners to stay overnight at the house on an agreed basis. In this way staff respect and promote personal and sexual relationships for residents. The management told me that although meals were initially cooked for all residents living at the home, within a few months they had all been provided with enough support and skills to cater for themselves with a weekly budget provided for their food. Residents are given money each week so that they can buy and cook their own food, with lockable shelves to store their provisions, so that they will be better prepared if they move on to a more independent placement. One resident told me that they are able to cook cultural foods with support from staff as appropriate. Other residents said that they sometimes cooked meals for other residents and shared other people’s meals as appropriate in group living. Only one person raised concerns about the weekly budget provided for food, and this was passed on to the management, who agreed to review this amount and consider more provision of staple foods for use by all residents. Ashness Two DS0000071324.V364167.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 the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are good at meeting people’s physical and emotional needs so that residents feel well supported. Although residents’ medication needs are met there is a need for more careful record keeping to ensure that they are adequately protected from errors in their medication. EVIDENCE: Residents that I spoke to told me that they were very happy with the level of support provided by staff, with regard to mental health, physical health needs and developing practical skills. One resident told me ‘they are really nice to you here.’ The care plans indicate how to respond to the needs and goals of residents. People files showed that health needs are responded to with evidence seen of referrals made to relevant professionals. In some cases residents have a regular contact with a Community Psychiatric Nurse. Given the complex needs and histories of each resident there is close contact between the home and the relevant psychiatric team. Regular progress reports are sent to other professionals as part of working in partnership with the Community Mental Health Team. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 15 Medication storage arrangements were appropriate, with the temperature of storage monitored regularly to ensure that it does not exceed 25°C. Staff have undertaken training in the administration of medication, and residents told me that their medication needs are met satisfactorily. All medicines received into the home are recorded and there is also a record of medicines returned to the pharmacist. Although some people do take prescribed medicines on an as and when basis for their mental health conditions, staff advised that these are asked for by the residents when needed rather than being offered by staff. they all appropriately and safely. The manager advised that weekly audits are undertaken regarding medication administration at the home. However during my inspection of medication administration records, I noted that there were some gaps in the recording of medication administered to residents in the last few weeks. A requirement is made accordingly. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 16 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): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents feel confident that their complaints and concerns will be listened to and acted on. They are protected by adult protection procedures that ensure their safety whilst at Ashness Two. EVIDENCE: Residents spoken to said that they felt able to raise their concerns or complaints with staff and managers and that their views are taken into account. The home has policies and procedures in place in relation to reporting and investigating complaints although the CSCI details need to be updated as noted under Standard 40. The complaints book indicated that no complaints had yet been made. It is recommended that all concerns raised by people living at the home be recorded, alongside timescales and action taken to address each issue, to evidence that the home is proactive at addressing issues before they become formal complaints. Staff have attended training courses on how to protect vulnerable adults from abuse and know what to do if they think a resident has been the victim of any form of abuse. In one case action had been taken by staff to minimise financial exploitation of a resident by people outside of the home. The home has procedures and policies on protecting residents from abuse including the local authority’s policy. Appropriate recruitment procedures are in place, and Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 17 staff spoken to were aware of the different types of abuse and appropriate action to take in the event of an allegation of abuse. The manager had not yet been able to undertake the local authority training in Safeguarding Adults due to no places being available on this training to date. It is recommended that he continue to attempt to undertake this training as soon as possible. Residents spoken to were aware of their rights and felt that they would be able to speak to staff or the management in the event of any related issue. The management advised that they were in the process of assisting a resident with regard to their human rights due to a delay in their being discharged from hospital including assisting the resident to obtain legal advice regarding their benefits, care-coordinator etc. Records of residents’ monies are kept that are signed by both the resident and a member of staff. However a requirement is made under Standard 41 to ensure that residents are further protected from financial abuse. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 18 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 the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Person living at the home enjoy an attractive and comfortable living environment that adds to their quality of life, and benefit from a home that is kept clean and hygienic. EVIDENCE: ‘The house is really nice’ one resident told me, its all newly decorated and we keep it clean.’ This was the comment of one resident. All residents were positive about their living environment and throughout the inspection appeared to feel at home at Ashness Two. The home is bright, comfortable and well decorated and furnished. The lounge has a television with a wide variety of channels available. There is a garden area at the back of the property with a table and garden chairs, and residents told me that they used this area when the weather was fine. The home is close to public transport and shops making it easier for the residents to take advantage of local community facilities. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 19 Staff and residents told me that repairs are dealt with promptly and there were no maintenance issues at the time of my inspection visit. A bike shed had been provided in the front garden area, with two bikes provided for use by residents, this service is commended for this practice. The provider advised that residents are being encouraged to undertake the cycling proficiency test prior to cycling on the roads. The provider advised that the fencing in the front garden was to be replaced shortly including a new garden gate. On the day of the inspection the home was clean and tidy. Residents appeared to take pride in the cleanliness of the kitchen. All bedrooms had been personalised and residents use the home’s laundry facilities with support from staff. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 20 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, 35 and 36. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a committed and experienced team of staff who have the skills to meet their needs. They are protected by the home having thorough recruitment procedures for new staff. Their mental health is promoted and their independence skills increased because of the skills and competence of staff, and their supervision by management. EVIDENCE: ‘They really treat you nice here’ one resident told me. Feedback from the other people living at the home was also very positive about the support provided by staff. I was able to interview one staff member in addition to speaking to the registered manager and provider. The staff member came across as a committed member of the team, who was very aware of the complex needs of the current group of residents. Throughout the inspection staff interacted positively and supportively with residents. All members of staff have achieved at least NVQ Level 2 in care, or are working towards this qualification, and all Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 21 had experience of working at the other home owned by the provider prior to working at Ashness Two. There is expertise within the team with regards to working with people with mental health needs in addition to some staff who are relatively new to the field. I looked at the staff files for the three staff who work at the home on a full time basis. All contained the information needed to evidence that all new staff in the home have had the appropriate checks made, including obtaining written references and satisfactory enhanced CRB disclosures. As a result residents are protected by the arrangements the home has in place when recruiting staff to work at the home. New members of staff have a planned induction into the roles and responsibilities of being a support worker. The staff team has attended a range of relevant courses, including adult protection, administration of medication, care planning, mentor training, passenger safety training and mental health awareness (including addressing challenging behaviour). This is in addition to training in essential areas such as first aid, food hygiene, fire safety, and health and safety. Staff records showed that each staff member receives regular one to one supervision sessions, so that their care practice can be developed and any training needs identified. The staff member interviewed said they felt well supported by management at the home. The manager advised that two staff members were due to undertake training in basis Cognitive Behavioural Therapy techniques that might be utilised in supporting residents within the home. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 22 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, 40, 41 and 42. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living at a home that is managed by a qualified and experienced team. The home is run in the best interests of the residents with their views and wishes taken into account. Policies and practices in the home generally ensure that residents are kept safe and secure whilst promoting their independence. EVIDENCE: The registered manager of the home spent five years working in the field of forensic mental health prior to working for Ashness Care Ltd. He has completed an NVQ level 4 in care management and is registered with a local college to complete the Registered Management Award units. The registered provider is also closely involved in the management of the home on a daily basis. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 23 People living at the home advised that the home is well run with priority given to meeting their needs. Discussion with the management team and staff showed that they have a good understanding of the needs and wishes of each resident. Residents were seen to be relaxed in the presence of staff and confident about interacting with them. As the home is relatively new, a full quality assurance audit has not yet been undertaken. However a quality assurance procedure is in place for the home. Residents interviewed said that they felt listened to by staff and that they were able to make comments about the running of the home. Monthly resident meetings are held, and I was able to look at the minutes which detailed subjects discussed including the home’s brochures, registering with a GP, and finances. Regular staff meetings are also held with minutes available for inspection evidencing that a wide range of topics are covered. As appropriate the manager had completed the Annual Quality Assurance Assessment for the home including detailed information about the running of the home. Information on the form was checked at the inspection and indicates that the manager is able to critically assess the quality of the service provided and work towards improving standards further. A detailed set of policies were available for the home as appropriate, and the staff spoken to told me that they had read through the policies as part of their induction for the home. It is recommended that all relevant policies for the home be updated to include the current CSCI contact details. The manager took me through the procedures for supporting people with their finances, and these were generally rigorous. However I was concerned to learn that the pin number for one resident’s bank card was being kept in the staff office. Following discussion with the home’s management regarding the need to find a balance between concerns about the resident losing their independence, whilst ensuring that they are safeguarded from financial abuse, it was agreed that a risk assessment be undertaken with regard to the way in which an identified person is assisted with their finances at the home. In addition the manager agreed to conduct a review regarding the storage of residents’ pin numbers to ensure that they are not at risk of financial abuse. Shortly after the initial inspection visit, the provider advised me that this issue had been discussed at a multi-disciplinary meeting for the identified individual, with appropriate actions agreed. A range of records were looked at, including health and safety certificates and fire safety logs. These records were detailed, with up-to-date gas, electrical installation and portable appliances testing certificates. A detailed fire safety risk assessment of the premises was available and regular fire drills are held. However there had been a gap of two weeks since the last fire alarm test recorded, and a requirement is made accordingly. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 24 Inspection of food storage arrangements showed that some opened perishable items were stored in the refrigerator, without labelling as to the day on which they had been opened or were due to be discarded. Whilst it is appreciated that this can be difficult to implement whilst encouraging residents to be independent, it is necessary to ensure the hygiene of food provided to people living at the home. Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 25 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 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 X 12 4 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 3 2 2 X Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 YA20 Regulation 13(2) Requirement Timescale for action 13/06/08 2. YA41 13(6) 16(2l) 3. YA42 16(2j) 4. YA42 23(4cv) The registered persons must ensure that there are no gaps in the recording of medication administered to residents to ensure that their medication needs are met appropriately. 20/06/08 The registered persons must ensure that a risk assessment is undertaken with regard to the way in which an identified person is assisted with their finances at the home. A review must be undertaken regarding the storage of residents’ pin numbers to access their bank cards, to ensure that they are not at risk of financial abuse. The registered persons must 04/07/08 ensure that perishable items in the refrigerator and freezer are labelled with the day on which they are opened and the date by which they must be discarded to ensure that people living at the home are protected from harm, by safe food handling procedures. The registered persons must 13/06/08 ensure that there are no gaps in the practice of testing the fire DS0000071324.V364167.R01.S.doc Version 5.2 Ashness Two Page 27 alarm on a weekly basis, to ensure that staff and residents at the home are adequately protected in the event of a fire. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is recommended that in time more detail be included within people’s care plans, and with regard to recording progress made to reach goals, so that these are more personalised to the needs of each person living at the home. It is recommended that more general risk assessments be recorded for people living at the home in addition to mental health risks identified, to ensure that they are protected from harm in all relevant areas. It is recommended that all concerns raised by people living at the home be recorded, alongside timescales and action taken to address each issue, to evidence that the home is proactive at addressing issues before they become formal complaints. It is recommended that all relevant policies for the home be updated to include the current CSCI contact details. 2. YA9 3. YA22 4. YA40 Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 28 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 Ashness Two DS0000071324.V364167.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!