Inspection on 19/10/09 for Ashbourne Lodge Rest Home

This is the latest available inspection report for this service, carried out on 19th October 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Ashbourne Lodge Rest Home Ashbourne Lodge 8 Seventh Avenue Blackpool FY4 2ED     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jacqueline Riley     Date: 1 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Ashbourne Lodge Rest Home Ashbourne Lodge 8 Seventh Avenue Blackpool FY4 2ED 01253341424 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: etone101@hotmail.com Miss Jeanette Dervish care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ashbourne Lodge is situated in a residential area south of Blackpool. The home is registered to accommodate a maximum of 24 persons. The accommodation comprises of 3 double bedrooms and 18 single bedrooms, 13 of which have en-suite facilities. There are two lounge areas. The rear lounge is also a dining room. There is a large rear garden which is not overlooked. A passenger lift enables people to have access to the first floor and aids are provided throughout the home to assist residents with their daily lives.There is a Statement of Purpose/Service User Guide, which is given to all prospective residents or their relatives. This information explains the care service that is offered and what people can expect if they decide to live at the home. A copy of the most recent inspection report is given to all prospective residents and a copy is available in the home for anyone else to read if they wish. Information received on the day of the inspection (19th October 2009) showed the fees for care at the home at that time were from £303.52 to £364 per week with additional charges for hairdressing, newspapers and chiropody. Care Homes for Older People Page 4 of 24 Over 65 24 0 0 2 1 0 2 0 0 8 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key inspection of the home was undertaken which included an unannounced visit to the service on 19th October 2009 and lasted approximately 5 hours. We spoke to eight people living there as well as the owner, manager and four staff members. The care records and other records relating to the care people receive were looked at. We also looked around the home with the manager and spent time talking to people living there. In addition we received a number of surveys from people living at the home and took their comments into account when preparing the report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an annual assessment of the quality of their service. This document is called Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus on our inspection activity. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: The home should continue to improve the environment so that it is a comfortable and well maintained place for people to live. Care Homes for Older People Page 6 of 24 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 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 Older People Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. There are admission and assessment procedures in place to ensure the care needs of people are being met. Evidence: We looked at the records of three people living in the home. We saw they had assessment details from social workers and other healthcare professionals. The information we looked at showed the home is provided with a full history of the care needs of the person to be admitted so that they know what the needs are and whether they will be able to manage those needs. In addition the home has its own assessment format which they use to determine how the needs of the person will be met when admitted to the home. Staff we spoke to said they felt they find the information useful and it helps them recognise individual needs at the point of admission to the home. People we spoke to said they had been asked about their needs before they came into Care Homes for Older People Page 9 of 24 Evidence: the home, and that staff had been extremely helpful and made them feel comfortable when they went into the home. Care Homes for Older People Page 10 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Promotion of health is taken seriously, peoples welfare is monitored and their needs are met. Evidence: We found the home has worked hard to improve the care planning records for people using the service. They have developed a system which is clear and easy to follow. Staff spoken to said, Its much better now, and we are responsible for putting some of the information in the records, we have developed the care plans so that all the information is in one place and easy to follow. We saw good information about individual health care needs and how they were being met. Two people spoken to said they are helped to attend hospital and GP appointments. The records show there are risk assessments in place for people, which highlight what the risk is, what level of risk there is to the person and how that risk will be managed. Staff spoken to said they think people are protected by the risk assessment systems Care Homes for Older People Page 11 of 24 Evidence: they are now using. We saw all plans of care are being reviewed monthly and where possible the person is involved in this review so that they know their needs are being monitored and changed where necessary. By looking closely at the records there is evidence the home has good links with other health care professionals including, GPs, districts nurses and social workers. People who require additional health care have records in place to monitor their care, including appointments, reasons for them and what treatment if any has been prescribed. The way the home manages its medication has improved. We saw evidence the home is working with the supplying pharmacist, who has provided up to date good practice guidance and training for staff responsible for administering medication. We found the way medication is recorded has improved and that returns are carried out monthly so that there is no excessive stock of medication in the home. We looked at three records and found them to be complete. The way the home stores medication is in locked purposeful facilities to ensure security. We saw peoples privacy and dignity is respected by looking at how staff talk to and respond to people. We saw staff are respectful and sensitive to people needs by the way we observed them talking to residents and assisting them. Staff we spoke to said they feel they treat people in a way they would expect their own family to be treated if in care. Care Homes for Older People Page 12 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Social activities and meals provide daily variation and interest for people living in the home. Evidence: We spoke to some of the people living at the home and staff about what the routines are. They told us they are flexible so people can choose how they want to spend their time. This includes no restrictions on what time people get up and go to bed, whether they choose to stay in their rooms or use the communal facilities. We saw people using various parts of the home throughout the inspection. Some people choose to stay in their rooms where they have included TV and audio equipment of their choice as well as furnishings which make it homely. The home has developed a full activity programme since the previous inspection which includes a variety of themes including entertainment, trips out either as a group or individually, pamper days, manicure, board games etc. People we spoke to said they had enjoyed a trip to the Illuminations, others said they like to go out with staff shopping sometimes. Three people were keen to show their manicured nails and said they enjoyed the pampering. Staff told us they are given the time and the resources to provide activities which they said was usually enjoyed by everyone although they Care Homes for Older People Page 13 of 24 Evidence: respect peoples rights if they choose not to join in. We spoke to people about meals in the home. They told us they enjoyed all the meals and the staff know if they dont like something. We spoke to the cook who was preparing lunch. They told us they use fresh ingredients wherever possible and they are provided with information about peoples individual nutritional needs when they are admitted, so they can identify any specific nutritional need if necessary. Care Homes for Older People Page 14 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Complaints are handled well and taken seriously ensuring people feel listened to. Staff have access to safeguarding protocols to protect people. Evidence: We looked at the homes complaints procedure. It is made available to people using the service so they know how to raise any concerns or complaints. Surveys we received told us people know how to make a complaint. People we spoke to said, if I am not happy about something I tell the staff and it usually gets sorted out. We spoke to the manager about how people are protected and they showed us records of staff training in this area. Staff we spoke to said they have received training in protecting people and this is also used as part of the staff induction programme so the manager is satisfied all staff have the information they need to act on any suspicion of abuse. There have been two safeguarding investigations since the previous inspection and the manager and staff worked closely with the investigation team for a satisfactory outcome. Care Homes for Older People Page 15 of 24 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, 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. 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 live in suitably adapted, clean and comfortable surroundings. Evidence: We looked around the home with the manager. There have been some improvements including a wet room on the first floor which people said they liked to use. Comments included, its easier to use, I like the new bathroom, you dont have to climb in and out of the bath. There are also two bathrooms on the ground floor for people to use, with lifting equipment for people with limited mobility. The home is generally well furnished and decorated although some areas remain in need of decoration and replacement carpets, but the owner told us this is part of the refurbishment programme and it is improving all the time. People we spoke to told us, I like my room its cosy and I have what I want in it, I like to use my room as I please, its got everything I need. There are two communal lounges with one incorporating the dining area in a rear conservatory. Most people use this room, using a range of seating for people with various mobility issues. We saw there are suitable walking aids and adaptations including wheelchairs and hoists so that people with limited mobility are assisted. There was a previous immediate requirement for the water temperature to be Care Homes for Older People Page 16 of 24 Evidence: regulated. We checked water at bathroom sources and in some rooms. All were found to be satisfactory with regulators fitted to all water outlets for the prevention of scalding. There is a well maintained rear garden area which is private and not overlooked. People we spoke to said they like to use the garden in good weather. Some peoples rooms overlook the garden and they have access to it from their rooms. Care Homes for Older People Page 17 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The procedures for recruiting staff are good, ensuring the safety and protection of people. People are supported by well trained and effective staff so their needs can be met. Evidence: We spoke to the manager about how staff are deployed for the benefit of people using the service. We looked at the staffing rota which showed there are sufficient numbers of staff on duty at any one time so the needs of people living there can be met. In addition the manager takes care to ensure the skills of the staff team are mixed in order to provide consistent levels of support and for the staff team to develop further. Staff we spoke said they thought the owner and manager supported them well, and listened to them. Comments included, We work really well together as a team, we bounce ideas of each other, and I think our ideas are listened to. We looked at the homes training records and found there is a full range of training for staff, including mandatory training in moving and handling, first aid, health and safety and safeguarding people. In addition all staff either have a national care qualification or are currently undertaking training in a qualification. Staff spoken to said they are encouraged to attend training for their personal development. We looked at three staff files. They showed us staff are recruited safely using Care Homes for Older People Page 18 of 24 Evidence: procedures which take into account, qualifications and experience, their suitability for the role, references, Protection of Vulnerable Adults (POVA), Criminal Record Bureau (CRB), in order to make sure people are protected. Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The home is managed well with systems and policies in place for the safety and protection of people living there. Evidence: We saw the home has undergone a full review of all the systems it has in place since the previous inspection to ensure it meets with the requirements of the Care Homes Regulations 2001. We found the home is being run in the best interests of people using the service, comments included, they are really good with us all and make sure we get what we need, the manager has always got time for you. We saw the manager has developed a thorough supervision programme for the staff team. The records we looked at showed the staff are supervised regularly and their personal and professional development is identified and this is monitored and followed through so that there is evidence of the support they are receiving. Comments Care Homes for Older People Page 20 of 24 Evidence: included, supervision is taken seriously and we talk about how I can develop in my job, we are really encourage to go further and take courses whenever they come up. The manager has put in systems which help staff to contribute to the recording of care needs in records which are easy to follow. In addition the manager has implemented risk assessments to meet the requirements of the Mental Capacity Act 2005, whereby a Deprivation of Liberty Safeguarding (DOLS), is carried out for people living there. If it is identified a person is being deprived of their liberty in order to meet their care needs and in their best interests a referral is made to Social Services for this to be recorded, monitored and reviewed. The manager has undertaken training in this area so that they are suitably qualified to carry out this assessment. We looked at how the home gains the views of people using the service and found there are records of staff and resident meetings so that people have the opportunity to contribute to the development of the service. People are also given questionnaires about how the home is run and to offer any comments they may choose for the development of the service. We saw there is a clear line of management responsibility and staff communicated well with the manager and the owner throughout the inspection at the home. By looking at records we saw regular tests and servicing of essential equipment including lifting equipment, gas and fire were up to date. The homes hard wire electric certificate was out of date however the owner has arranged for this system to be serviced in the immediate future. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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