Inspection on 18/05/10 for Ashby Court Nursing Home

This is the latest available inspection report for this service, carried out on 18th May 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashby Court Nursing Home 08/06/06

Ashby Court Nursing Home 07/11/05

Ashby Court Nursing Home 19/05/05

Ashby Court Nursing Home 08/12/04

Ashby Court Nursing Home 19/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Random inspection report Care homes for older people Name: Address: Ashby Court Nursing Home Ashby Avenue Hartsholme Lincoln LN6 0ED two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Angela Kennedy Date: 1 8 0 5 2 0 1 0 Information about the care home Name of care home: Address: Ashby Court Nursing Home Ashby Avenue Hartsholme Lincoln LN6 0ED 01522695458 01522696252 cathytrevor@lacehousing.org enquiries@lacehousing.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Cathy Trevor Type of registration: Number of places registered: Conditions of registration: Category(ies) : LACE Housing Limited care home 42 Number of places (if applicable): Under 65 Over 65 42 old age, not falling within any other category Conditions of registration: 0 The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following category:- Old Age, not falling within any other category (OP) (42) The maximum number of service users to be accomodated is 42. To be able to admit the named person of category PD (under 65 years) named in variation application number V35766 dated 12 October 2006. Date of last inspection Brief description of the care home Ashby Court is registered to provide personal and nursing care to up to 42 people of both sexes over the age of 65 years. The two-storey property is purpose built. It was Care Homes for Older People Page 2 of 11 Brief description of the care home originally designed as warden-controlled accommodation. The home is owned by L.A.C.E. housing association which is a non-profit making organisation providing housing and care services for older people. It is situated in a residential area close to Hartsholme Country Park. There are small local shops and a post office within 300 yards. It is on a bus route into the city of Lincoln, about 3 miles away. A day centre is attached to the home where residents can use the facilities as they choose. These include an activities room with stage and dance floor, library, shop, coffee shop, extra bathing facilities and a hairdressing salon. Each accommodation is a separate flat, with a bedroom-cum-sitting room, kitchenette and shower with toilet. Each flat has ample storage space. The flats look out onto attractive gardens or parkland across the road from the home. There are 37 single and three double flats. One of the doubles is currently used as single accommodation. Accommodation is available on two floors with access to upstairs via a passenger lift, for people with limited mobility. Communally, there are two lounges, a dining room with an extension, two bathrooms, and toilets situated near the lounges and dining room. These are in addition to the facilities provided by the day centre. The Manager keeps printed copies of the statement of purpose, service users guide, and latest inspection report at the home readily available for people using or enquiring about the service. At the time of this inspection visit the fees per person were dependent on assessed need and ranged from £396.00 to £557.70 per week. Care Homes for Older People Page 3 of 11 What we found: The purpose of this Random unannounced Inspection was to check compliance with the Care Homes Regulations 2001 in a narrow focus of Inspection activity and in preparation for the registration transfer under the Heath and Social Care Act 2008. We have not visited the home since its last key inspection on the 24th May 2007 when the current quality rating was made. We met with the nurse who was in charge of the service on the day of this visit. The registered manager was not on duty on the day of this visit, but was at the service for part of the visit and was spoken to briefly. At this inspection we case tracked one person who used the service.Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at support plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. The person case tracked was able to express their views of the service and the support it provided. Their views are included within this report. One member of staff that worked at the service was spoken to and their views and opinions of the support provided and the training given to them is included within this report. The comments provided in surveys received from five people that used the service and three staff surveys are also reflected throughout this report. We looked at other documents to show us how complaints were managed and how people were protected from abuse. We looked at medication management to enable us to assess if safe practices were in place. We looked at the quality assurance processes in place. This enabled us to assess if people using the service were supported to have their say in the standards of care provided and identify areas where they felt improvements could be made. We were given a brief tour of the home. This enabled us to assess if the environment was maintained, suitable for its stated purpose and to check that any specialist equipment needed was available. What the care home does well: Peoples surveys showed that they knew who to speak to if they were unhappy and that they knew how to make a complaint. One comment was, I would go to the office. The person we spoke to on the day of our visit told us that they were not aware of how to make a complaint, but said they would speak to staff and find out if they needed to.We Care Homes for Older People Page 4 of 11 looked at how the service dealt with complaints and saw that this was done in an open and transparent way that addressed concerns promptly and effectively.Three staff surveys showed that they know what to do if someone had concerns about the home. The service had a copy of the Local Authority Policy on Safeguarding Adults. This ensured that the staff were able to follow the correct procedure if they had any concerns or suspicions of abuse, as the Local Authority take the lead role in all safeguarding referrals and investigations. Staff training certificates for safeguarding adults was displayed on the notice board and demonstrated that staff were kept up to date in this practice. One member of staff was spoken with and they confirmed that they had undertaken safeguarding training. Three safeguarding referrals have been made by the home to the Local Authority safeguarding team in the last twelve months. Two of these referrals were investigated by the home and one was referred back to the registered manager to investigate. Of these, two have now been investigated and resolved. One investigation remains ongoing at the time of this visit. This investigation will remain open until all agencies involved have completed their investigations. The environment was well maintained. All areas that we looked at were decorated to a good standard. We spoke to one person who used the service and visited them in their flat. They told us that they really liked the set up in their flat and said, Its a nice place to stay, Im, very happy.All surveys from people using the service were unanimous in stating that the home is always fresh and clean. The services that were available to the people living at the home included a shop that was situated centrally in the home and a mobile shop which also gave people the opportunity to make purchases. A hair salon was available from Monday to Friday and people made appointments in advance to use this service. A day service was also available to the people living at the home throughout the week and activities and entertainment was also provided by the home in addition to this.Information regarding these activities was seen on the notice boards situated within the main corridor. The person we spoke to on the day of our visit told us that there was always something to do.The information in the surveys we received form people living at the home also confirmed that activities were available. During our tour of the home we saw that there was three mobile hoists for staff to use to support people with mobility needs and a bath hoist was also seen. This ensured that people with mobility needs could be transferred in a safe way. We spoke to a member of staff who told us that they enjoyed working at the home. They felt that the staffing levels were sufficient and confirmed that five or six staff were on duty throughout the day. The person living at the home that we spoke to told us that the staff do well, their a nice bunch of people, no problems at all. Training certificates were displayed on wall in the corridor. This showed us that staff were kept up to date in mandatory training. This ensured that staff were kept up to date with current legislation to ensure safe working practices were maintained.One member of the staff team was spoken with on the day of this visit. They confirmed that they were kept up to date with training and said there was enough training. Information within surveys Care Homes for Older People Page 5 of 11 received from staff also confirmed this, such as I am well catered for in this area, they also fund any training and I am well catered for in training. Not only do they provide mandatory training, they also fund any training I need and pay me to attend. The member of staff spoken with on the day of this visit said that management were supportive and that everybody worked well as a team.Staff surveys told us that they met with the manger on a regular basis and were given support and discussed how they are working. The surveys also told us that staff have the right support and told us that the service does well by providing a caring environment with well trained, knowledgeable staff and always trying to give residents a good quality of life. As the registered manager was on special leave, arrangements were in place to ensure a designated acting manager was in place during this period. This ensured that both staff, people using the service and their representatives were at all times aware of the management arrangements in place should they have issues they needed to discuss. We saw evidence that showed us that people using the service had been informed of the management arrangements during the registered managers absence. The quality assurance processes in place were generally well met. This was done through newsletters both for staff and people using the service, these were displayed in the reception area. Staff meetings were held although the minutes available for us to view, were from a staff meeting held on the 17th September 2009. The nurse in charge on the day of this visit confirmed that she had attended a staff meeting earlier in the year. However the minutes to this meeting could not be located. Records of meetings held by the people using the service were seen. These were dated 11th Feb 2010. These minutes showed us that people using the service were involved in the planning of activities,as recommendations were recorded as to where people wished to visit, such as a mystery tour and a trip to skegness. What they could do better: At the last key inspection in 2007 it was found that care plans were not comprehensively completed. At this visit we found that some improvements had been made to ensure more detailed information was provided within some of the care plans we looked at. As the person we case tracked had recently moved to the home, some of their care plans were quite limited in detail. For example, the persons mobility care plan said walks with a stick, no further information was given regarding if any support, interventions or supervision was needed.Their care plan regarding eating and drinking stated appears to be alright with both food and drink,again no further information was provided such as dietary preferences or requirements. However two of the care plans for this person were more detailed as apart from the basic information provided in their initial care plan, a care plan summary had also been completed. These care plan summarys were more specific in detail and clearly instructed staff on what the person was able to do for themselves and areas were they needed staff support or intervention. These care plan summarys had been signed by this persons relative and the member of staff completing the plan.The nurse in charge on the day of Care Homes for Older People Page 6 of 11 this visit told us that care plans were further developed with care plan summarys once the staff got to know the person and said that the initial care plans provided baseline information. In the file of the person case tracked only one risk assessment was in place. This was a waterlow assessment that told us about the person skin condition and provided a basic assessment on areas that could have an impact on the likelihood of them developing pressure sores. Such as their mobility, age, skin type, weight and diet. Apart from this assessment no other assessments were in place. Although the waterlow assessment told us that this person was fully mobile, their care plan told us that they walked with a stick,however there was no mobility assessment or falls assessment in place to identify if this person needed any support or was at risk of falls.The waterlow assessment told us that they ate a normal diet, but there was no nutritional assessment in place to show that their nutritional needs had been assessed. The medication held for the person case tracked was checked against their medication administration record and corresponded. There were no gaps on the medication administration record , indicating that their medication was given as prescribed. As the Person case tracked did not self administer their medication the records of a person who did self administer was looked at. There was no risk assessment in place to demonstrate their capacity to self administer or to retain their own medication. Discussions with the nurse in charge on the day of this visit confirmed that this persons G.P. had organised the medi dose system that this person now used to self administer. This indicated that the G.P had been involved and we could assume that this means the G.P was confident that this person had capacity to self administer their medication. However there was no record to show us that this was the case. At the last key inspection in 2007 it was found that the provider had not visited the home on a regular basis to undertake the monthly review of the service and report on it, as required. These visits are known as Regulation 26 visits. At this visit we found that regulation 26 visits were being undertaken but the records we saw did not demonstrate that these were being done on a monthly basis. The records available to us were for the 18th January 2010, the 15th September 2009 and the 10th June 2009. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 1 8 13 Risk assessments must be in 16/08/2010 place to assess each persons mobility, risk of falls and nutritional status and appropriate actions must be put in place for any identified risk. These assessments should be reviewed on a regular basis. To ensure people using the service are supported in a safe way. 2 9 13 People that wish to self 19/07/2010 administer and retain their medication must have a written assessment in place that demonstrates that they have the capacity to do so.This assessment should be reviewed on a regular basis. To ensure that people who self administer their medication are able to retain and administer their medication safely and as prescribed. Care Homes for Older People Page 9 of 11 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The information within the initial care plans undertaken should provide the staff with detailed information on the strengths and needs of each person admitted to the home. This will ensure the staff can support them effectively without compromising their independence or the care they receive. The provider should undertake a monthly audit to report on how the home meets the needs and wishes of the people using the service. A copy must be made available to the manager. 2 33 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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!