Care Home: Asquith House

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What the care home does well What has improved since the last inspection? A number of bedrooms have been re-decorated and a bathroom has been refurbished so people continue to live in well maintained surroundings. The care needs of the people who live at the home have been re-assessed to make sure that their needs can still be met there. What the care home could do better: Staff should be reminded of safeguarding adults procedures so they know what to do if an allegation or instance of possible abuse occurs. CARE HOME ADULTS 18-65 Asquith House 8 Waterloo Road Chester Cheshire CH2 2AL Lead Inspector Mr Val Flannery Unannounced Inspection 4 & 9 October 2007 14:30 Asquith House DS0000006528.V345149.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 Asquith House DS0000006528.V345149.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. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Asquith House Address 8 Waterloo Road Chester Cheshire CH2 2AL 01244 381474 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) www.macintyrecharity.org MacIntyre Care Cherie Ann Jenkins Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: *Up to 6 service users in the category of LD (Learning disability). 3rd August 2006 Date of last inspection Brief Description of the Service: Asquith House provides accommodation and care for six adults with a learning disability. It is set in a residential area of Chester, close to local amenities and the city centre. The home is on three floors; access between the floors is via the stairway. All six bedrooms are single and five of them have en-suite showers and toilets. There is one communal shower/bathroom/toilet on the first floor and a toilet on the ground floor. There is a lounge and a dining room on the ground floor. The garden at the back of the home provides a wellmaintained and secure area for use by service users. Staff are on duty twentyfour hours a day to provide care for the people who live in the home. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 4 and 9 October 2007 and lasted 5.5 hours. The visit was carried out by Val Flannery, Regulatory Inspector. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for residents, families and health and social care professionals, such as doctors and social workers, to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of the people who live in the home and staff were also spoken with and they gave their views about the service. What the service does well: The home promotes equality by treating people as individuals to make sure their diverse needs are appropriately met. People who may wish to live in the home would have their needs assessed before they move in. They are given written information about the home and can visit or stay on a trial basis. This ensures they and their families have all the information necessary to decide whether their needs can be met at the home. Care plans identify the health and personal care needs of the people who live in the home and include information on what staff need to do to meet those needs so that people receive the care they need in the way they prefer. Relatives and friends are able to visit the home as they wish so the people who live there are able to keep in touch with their families. The people who live in the home said the food offered is usually good so they enjoy a varied diet. People who live in the home are asked for their views about the home and there is a thorough complaints procedure, so they know their concerns will be listened to and acted upon. The home is well maintained with good standards of décor and furnishings so that the people who live there live in safe, comfortable surroundings. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 6 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. Asquith House DS0000006528.V345149.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 Asquith House DS0000006528.V345149.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 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available and full assessments would be carried out to make sure that the needs of anybody wishing to move into the home could be met there. EVIDENCE: Since the last visit to the home no new people have moved in. The manager confirmed that the organisation’s assessment procedure for people moving in would be fully implemented for prospective users of the service. The care files for one of the people that live in the home were seen during the visit. Two files are kept on each person; one is called ‘Care Package’ and the other covers person centred planning. The records showed that changes to the person’s assessed care needs are appropriately dealt with at the home. Although the people that live in the home have restricted capabilities, changes to the way they are cared for are discussed with them. Four people spoken with during the visit said that they ‘like it here’. Staff spoken with said the needs of the people who live in the home are monitored by staff, and other professionals as appropriate. Care plans are updated to Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 9 show how any changes are to be met. Care plans seen during the visit showed that changes to care needs are recorded in the plans of care. A copy of the residency agreement between people who live in the home and MacIntyre are kept in the care files. Asquith House DS0000006528.V345149.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans show how the people who live in the home wish to live their lives and they are reviewed regularly to make sure they are kept up to date. EVIDENCE: The records checked for one person who lives at the home showed that their assessed needs are included in their plans of care. For example, the level of support they need with using the bathroom, dressing/undressing and moving about the home. During the visit, staff were seen helping the people and encouraging them to be as independent as possible. Records were seen that showed that person centred plans are in place for each of the people who live in the home. These include personal profiles and daily routines for each person. Four of the people who live in the home were spoken with during the visit. They said that staff help them. Staff were seen asking people where they Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 11 would like to spend their leisure time, what they would like for tea and what they had done during their daily activities. Risk assessments are in place to identify possible dangers to the people who live in the home. These cover the home environment and when they are using community facilities. People were seen moving freely between their bedrooms and the communal areas. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are helped to use community facilities so they can keep in touch with the local community and their friends and relatives. EVIDENCE: Two of the people who live in the home were seen returning for their daily activities. Records seen contained a weekly activity programme for each person that included trips to local shops, cinema and a disco. The needs of each person who lives in the home are such that they need different levels of help with their daily routine. There is a motor vehicle available at the home that is used to take people out to their daily activities and local places of interest. Some of the people who live at the home make a monthly contribution towards the running costs of the vehicle. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 13 Risk assessments are in place to make sure that people are as safe as possible when they’re taking part in their daily activities, both in the home and in the community. Relatives and friends of the people who live in the home are able to visit at any reasonable time and are made welcome. Records seen contained details of family contacts and relationships so staff could help people stay in touch with their families and friends. During the visit staff were seen caring for the people who live in the home by, for example, helping them with personal care and moving about the home. Although a number of the people who live in the home have communication difficulties, it was evident visit that staff were aware of their needs and how these were to be met. The record of food offered showed that people are offered choices at each meal. During the visit staff were seen preparing the evening meal with help from the people who live at the home. Asquith House DS0000006528.V345149.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans set out how the people who live in the home are to have their personal and healthcare needs met. This helps ensure their well-being and that their privacy and dignity is respected. EVIDENCE: During the visit, staff were seen providing personal support for the people who live in the home with, for example, using the bathroom/toilet and having a drink. Staff spoken with knew the level of help each person needed with these tasks. Records seen during the visit showed that the personal care needs of the people who live in the home have been assessed and plans are available that show how these needs are to be met. Individual healthcare files are kept for each person living at the home. These showed that they receive visits from doctors, nurses and other healthcare professionals. Letters were seen that showed they are supported by staff to attend hospital appointments as necessary. The record of medication administered by staff was seen and was satisfactory. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 15 During the visit to the home staff were seen caring for service users and responding to their requests for help. Staff were aware of people’s likes and dislikes and how they wished to be cared for. Asquith House DS0000006528.V345149.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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure for the home and there is a comprehensive adult protection procedure for the home although some of the staff need to be reminded of the guidance so they know what to do if there is an allegation of abuse. EVIDENCE: A copy of the complaints procedure is on display in the home. Details on how to contact the Commission for Social Care Inspection are included in the procedure. CSCI has not received any complaints about the home. A copy of the complaints procedure has been provided in picture format that makes it easier for service users’ to understand. The complaints record seen during the visit showed that the home has received two complaints since the last visit. These were dealt with appropriately by the home MacIntyre Care has an Adult Protection procedure, a copy of which is kept in the home. It includes a copy of the government guidelines ‘No Secrets’. Since the last visit, an investigation is being carried out within the home following an anonymous allegation. A number of staff have either left the home or been redeployed within MacIntyre. Staff spoken with said they had not received further training on protecting people from abuse or any additional support from the organisation. The manager confirmed that the organisation has ensured that the staff have read and discussed the procedure and guidelines on adult protection and that staff had previously attended training on this subject. Further training on protecting adults from abuse has been organised for the staff team. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 17 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, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the bedrooms are single with five of the six have en-suite showers and toilets to help ensure that the privacy, dignity and independence of the people who live there are maintained. EVIDENCE: The home is well maintained and is suitable for the needs of the people who live there. It is decorated and furnished to create homely and comfortable surroundings. During the visit, the bathroom on the first floor was being redecorated and re-furnished. All the bedrooms are single and five have en-suite bathing and toilet facilities. The two bedrooms seen were individually decorated and furnished. The layout of the bedrooms ensured that the people were able to move freely about their rooms. One of the people spoken with said he likes his bedroom. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 18 There is a communal toilet on the ground floor, and a combined bathroom/ shower/toilet on the first floor. The home has one large communal lounge and a separate dining room, both on the ground floor. The enclosed garden to the rear of the home is well-kept and easily accessible to service users. There is a motor vehicle available for the people who live at the home and those who are on the higher rate of disability living allowance pay a contribution towards its running costs. On the day of the inspection home was clean, tidy and free from unpleasant odours. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of their roles and responsibilities. This will help ensure they have the necessary skills to meet the needs of the people that live in the home. EVIDENCE: The staffing rota seen during the visit showed that there are normally two staff on duty during the day and one waking staff on duty during the night. Four staff were spoken with during the visit. They confirmed that they receive individual supervision from the manager. They also said they have access to training opportunities provided by MacIntyre. Training records seen showed that the following courses are provided for staff: administration of medication updates, health/safety, risk assessment, fire awareness, first aid and manual handling. One of the staff spoken with said they had received induction training when they came to work in the home. It is the policy of MacIntyre Care that all staff achieve a qualification such as NVQ. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 20 During the visit, staff were seen caring for the people who live in the home and offering them support and encouragement. People were seen communicating their needs to staff and were comfortable in approaching staff for help with personal care. Two staff talked about the recent incidents in the home and how this had affected the staff team. They felt that ‘things are beginning to settle down and get better’ Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed so that it is run in the best interests of the people who live there. EVIDENCE: Since the last visit the manager has assumed responsibility for Asquith House only and is no longer joint manager for another MacIntyre home in Chester. She is allocated nineteen and a half hours for management duties at Asquith House; the remainder of her time is spent as part of the team caring for the people that live in the home. A senior support worker supports her to manage the home. A number of the staff spoken with said they are ‘happy with the overall management of the home’. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 22 During the visit the following records were seen: : accident records : fire safety tests : portable appliance tests (PAT) : record of monthly health and safety checks carried out by the manager. These were satisfactory The people who live in the home and the staff spoken with said it’s better having a manager with responsibility for Asquith House only. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 23 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 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 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 Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 24 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 Refer to Standard YA32 Good Practice Recommendations Those staff who have not received refresher training on the procedures for protecting vulnerable adults from abuse should undertake this as soon as possible. Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Asquith House DS0000006528.V345149.R01.S.doc Version 5.2 Page 26 - 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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