Better Outcomes for People with a Learning Disability

Quality Network Public Statements

Ashcroft Care Services Public Statement 1999

Our services

Ashcroft Care Services provides residential placements in East Surrey and West Sussex for adults with learning disability who present with behaviours which challenge services. We serve a total of 57 people in 11 houses, the largest accommodate 6 people and the smallest 3. Our aim is to provide people with high quality homes from which they can build fulfilling lifestyles with high levels of support. Individually designed day programmes are set up for each client, using community resources as well as more specialised provision of our own. Ashcroft employs its own Clinical Psychologist, Behaviour Nurse Specialist and Clinical Manager to provide analyses of behaviours which challenge, to advise on appropriate interventions, to assist staff in their implementation, and to evaluate the outcomes.

The Review took place between January 13th and February 3rd 1999. Three services were looked at - two homes for 6 people and 1 home for 4 people. Six service users were visited in total. The services and the people visited were representative of the broad spectrum of care and support needs which Ashcroft sets out to meet.

The Service Review Team consisted of a Quality Coach from the Quality Network and the Development Manager of Ashcroft Care Services, plus 6 visitors who were -

• A Care Assistant (from another Ashcroft home)
• A Home Manager (from another Ashcroft home)
• One of Ashcroft's Proprietors.
• Two independent Advocates from the East Surrey Advocacy Project (who had not previously had contact with our services)
• A Parent of a child with Autism and behaviour which is challenging (who does not use our services)

Each visitor made a minimum of 3 visits to the service user they were matched with. The visits took place at different times of the week and in different settings.

 What was going well for people visited

The Service Review Team concluded that -

• The homes visited are very pleasant and of a high quality, providing service users with a homely and supportive atmosphere. Personal privacy is valued and respected.
  
• Staff are very open and caring, demonstrating commitment to the people they serve. They are helping service users to make choices, supporting them and respecting their decisions. Overall service users are listened to in a meaningful way and staff were observed responding to them as equals.
  
• Staff support service users' skills in many aspects of daily life, including some opportunities for supported work.
  
• Ashcroft demonstrates the ability to support and work with people whose behaviour is very challenging. Individuals who have presented significant challenges have been enabled to progress and to develop towards more choice, independence and integration in their daily lives.
  
• Staff ratios are high and offer levels of support to each service user which enable them to develop
  
• Ashcroft supports service users in an impressively wide range of activities outside their homes. Service users are present in their local communities and the service as a whole is proactive in achieving this.
• Ashcroft demonstrates commitment to assessing risk across its services, putting guidelines in place to assist risk management and providing a support network to service users and staff through the work of its Clinical Team and senior Managers
  
• Ashcroft uses local resources well to ensure that service users enjoy a healthy lifestyle and that their health needs are well met. The expertise of Clinical staff is used to lead and advise as well as accessing alternative therapies to meet a wide range of individual needs
  
• Ashcroft is supportive of service users' families, maintaining relationships and listening to everyone's views.
• Staff make the effort to maintain the friendship networks of service users.

• we want to see more varied choices offered to all service users, with additional support for those who find it difficult to make choices for whatever reason.
  
• we want to see more consistency in how service users are listened to and consulted with, especially people who have communication difficulties.
  
• we want to develop opportunities for service users to be more involved in ordinary activities at home.
  
• we want to help service users to develop their current friendship networks so that they can relate more fully to others in their local communities.
  
• we want to enable service users to move towards making bigger decisions in their lives and acquiring the skills to do this, whatever their abilities.
  
• we want to access and provide opportunities for service users to work and be of service to others.
  
• we want to help service users to have greater opportunity to live with people with whom they are compatible.

Action Plan

The main steps we intend to take as a result of the Review are -

• all staff across Ashcroft will receive training and support
  
• to provide greater choice for service users to increase and support service users' involvement in activities at home
  
• to enhance the ways in which service users' are listened to.

This process will be completed in all houses by July 2000

after training, each house will -

• develop its own plan to introduce greater choice, based on individual needs, skills and preferences. Progress will be evaluated for each user.
  
• review individual goal plans to promote involvement and adapt the daily running of the house and allocation of staff time accordingly.
  
• focus staff supervision more on individual development in listening and communicating responsively
  
• from April 1999, each service user's review will agree a goal selected and decided by the individual who will receive all support to carry it through and to increase their decision-making skills. Alongside of this, the Clinical Team will bring forward a plan to involve users in all important decisions affecting their lives by October 1999, and more attention will be focussed on existing service users' meetings in each house to increase and develop participation.
  
• each house will assess the impact of individual behaviours upon the interaction between people and put guidelines in place to maximise compatibility. This will be completed by July 1999. Independent Advocates will be sought, at least for those who are deemed especially vulnerable.
  
• Ashcroft will map all existing sources of (paid) employment and survey the work needs of all its service users by October 1999. Individuals will be matched to opportunities. Additionally, 2 supported (paid) work projects will be developed by Ashcroft by April 2000
  
• by October 1999, Ashcroft will map all existing and past friendships for each service user. Social activities in and between houses will be promoted. Common interests will be identified and service users will be enabled to come together to share them. Links will be made with supportive individuals and groups in the community.

For more information, please contact:

Ann Weeder
Development Manager
Ashcroft Care Services
The Old Repeater Station
Bonehurst Road
Salfords
Surrey RHI 5ED

 tel: 01293 431111
fax: 01293 431114

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Our services

Ashcroft Care Services provides residential placements in East Surrey and West Sussex for adults with learning disability who present with behaviours which challenge services. We serve a total of 67 people in 13 houses; the largest accommodate 6 people and the smallest 3. Our aim is to provide people with high quality homes from which they can build fulfilling lifestyles with high levels of support. Individually designed day programmes are set up for each client, using community resources as well as more specialised provision of our own. Ashcroft employs its own Clinical Psychologist, Behavioural Assistant and Clinical Manager to provide analyses of behaviours which challenge, to advise on appropriate interventions, to assist staff in their implementation, and to evaluate the outcomes.

The service review

The Review took place between June 14th and July 3rd 2000. Three services were looked at - one home for 6 people, 1 home for 5 people and 1 home for 4 people. Five service users were visited in total. The services and the people visited were representative of the broad spectrum of care and support needs which Ashcroft sets out to meet.

The Service Review Team consisted of two Quality Coaches from the Quality Network and the Development Manager of Ashcroft Care Services, plus 5 visitors who were -

• A Care Assistant (from another Ashcroft home)
• A Behavioural Assistant (from Ashcroft)
• A Leisure Development Worker from Surrey Mencap
• An independent Creative Arts Worker for people who have Learning Disabilities
• A Grandparent of an adult who uses Ashcroft Care Services

Each visitor made a minimum of 3 visits to the service user they were matched with. The visits took place at different times of the week and in different settings.

What was going well for people visited

The Service review team concluded that -

• The homes are of a high standard generally
• Relationships between staff and service users are generally very good - and were often observed to be "exceedingly good".
• Staff look to develop the potential of the people they serve.
• Ashcroft is improving the quality of life of people who exhibit challenging Behaviours
• People are enjoying a wide range of activities outside of their homes
• People are very much present in their local communities. They are using a wide range of community facilities, and some are beginning to be recognised and appreciated in their local communities.
• Some people have had the opportunity of paid employment and voluntary work has been introduced for some.
• People who have family links are receiving good support to maintain them. Ashcroft works hard to listen to family’s views.
• Ashcroft is trying to protect the more vulnerable from harm.
• Ashcroft is supporting people to stay healthy, ensuring good access to a wide range of health options/professionals and supporting active lifestyles.
• Generally in Ashcroft there is a culture of respect for the people the organisation serves.

What we need to do to improve and develop further

From discussion with the service review team -

• We want to ensure that all people are able to live in their homes without fear of harassment and abuse from others.
• We want to enable all people to have opportunities to be involved in important decisions in their lives
• We want to enable all people to enjoy constructive occupation between timetabled activities, and to ensure staff spend a high proportion of their time interacting with people to achieve this.
• We want to ensure that people have respect demonstrated with greater consistency in the way that they are listened to and their need to communicate is facilitated - especially people who have high care needs and/or communication difficulties.

Action Plan

The main steps we intend to take as a result of the Review are -

• Members of the senior management team will develop strategies and policies to negotiate with Purchasers so that all people will receive the support they need to live with others or indeed to live independently of others. This process will be completed by November 2000
• People will be involved in interviewing and employing staff who may wish to work in their home. This will include informal interviews by November 2000 and training to be involved in formal interviews by January 2001
• People in four houses will be involved in the inspection of their homes. This will include involvement in the monthly inspections by January 200 1. By July 2001 they will be supported to make inspections of other houses from the perspective of people who live there and are not yet able to undertake this task. People undertaking inspections will receive a fee for doing this work.
• People will be involved in setting the priority maintenance schedule for their homes each year by January 2001.
• Ashcroft will increase resources as necessary in each home to provide more varied means of occupation in leisure and ‘dead' time by December 2000.
• Each individual will be enabled to join with staff in undertaking household chores. Ashcroft will ensure that there is at least one skill-building programme for each person in place and monitored by July 2001.
• Ashcroft will build awareness of respect (and what it means) throughout the service - in its induction processes, through staff and clinical meetings, in staff and key worker supervision at all levels, and through reviewing its key worker manual. A measurement mechanism will be built in to observe the quality of staff-client interaction and listening.

For more information, please contact:

Ann Weeder

Development Manager
Ashcroft Care Services
The Old Repeater Station
5 Bonehurst Road
Salfords
Surrey RHI 5ED

tel: 01293 431111
fax: 01293 431114

What we found to celebrate about the service

1. Physical health of the people is very good.

2. There is a good choice of activities for people.

3. Staff are very committed and have formed good relationships with people.

4. People are treated with respect.

5. People have a lot of choice in their lives.

6. People are helped to develop their own individuality

7. People are helped to take control over their lives.

8. We are making inroads into helping people find work.

Important areas where the service needs change

1. People need help to build new friendships and help maintain them

2. Ordinary social contact needs to be fostered.

3. People need help to maintain positive mental health

4. We need to respect space in people’s lives.

5. People need to be able to choose who they live with

For more information contact:
Anne Hames Proprietor
Ashcroft Care Services
5 Bonehurst Road
Salfords Surrey
RH1 5ED