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Inspection on 02/02/09 for Ashdale Care Home

Also see our care home review for Ashdale Care Home for more information

This is the latest available inspection report for this service, carried out on 2nd February 2009.

CSCI 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashdale Care Home 42 The Park off Park Avenue Mansfield Nottinghamshire NG18 2AT     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 0 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Ashdale Care Home 42 The Park off Park Avenue Mansfield Nottinghamshire NG18 2AT 01623631838 01623631838 ashdalecarehome@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr A J Verjee,Mrs S A Verjee Name of registered manager (if applicable) Mrs Jean Dawson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: Service users may be within categories OP (26) or TI (4) within a total registration of 26 Date of last inspection Brief description of the care home Ashdale is a two-storey, privately run, 26-bedded care home providing nursing and residential care for people of both sexes over the age of 65 years. The home is a converted residential property that has been extended in keeping with the surrounding properties, providing 18 single bedrooms and 4 double bedrooms. It is situated in a quiet, residential cul-de-sac, away from the main road leading into the town centre of Mansfield, less than one mile away. This is the nearest area for shops, pubs, leisure facilities and entertainment. Access to the first floor is by a passenger lift and staircase. There are an adequate Care Homes for Older People Page 4 of 26 care home 26 Over 65 26 0 0 4 Brief description of the care home number of bathrooms, one with assisted facilities, and communal toilets for the number of residents. At the rear of the property is a small conservatory. At the front and rear of the property there are quiet, pleasant gardens. There is a car park for visitors. fees for the home range from £269.00 to £380.00 per week apart form the continuing care service, for which people are individually assessed. Care Homes for Older People Page 5 of 26 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: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they Care Homes for Older People Page 6 of 26 completed. The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: 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 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 –03000 616161. Care Homes for Older People Page 8 of 26 Care Homes for Older People Page 9 of 26 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 10 of 26 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. People are assessed prior to moving into the home to ensure their needs can be met. Evidence: The care file for one recently admitted person was seen. There was a completed assessment dated prior to the person moving into the home. There was also an assessment completed by the local authority and a further assessment completed shortly after admission. There were completed assessments seen in other care files looked at. The temporary manager said that she had gone to visit the person in a local hospital and had to check make sure they could meet the persons mobility needs. The person concerned said, It was all done very quickly, someone came and said they thought it might be suitable for me. Care Homes for Older People Page 11 of 26 Evidence: Staff said they are told about new people coming to the home and what their needs are. Staff said this gets them prepared. Care Homes for Older People Page 12 of 26 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. Peoples health, personal and social needs are met by care practices in the home, in a manner that promotes their privacy and dignity. Evidence: A new care planning system has been introduced and all care files have been changed over to this. A sample of five care files were seen and these were well completed and gave clear details as to how to meet peoples needs. There were risk assessments completed, where a risk was identified, for such things as risk of falls, use of bed rails, use of aids and any health concerns. One person said, I have a keyworker who will help sort out my room and do any shopping I need. The temporary manager said that a care plan writing course has been arranged for the nurses, who are responsible for completing the care plans. Care Homes for Older People Page 13 of 26 Evidence: Staff said they record a lot of information into care plans, such as personal care provided and weights. Personal care charts showed people receive regular assistance with maintaining their personal hygiene and a record of any health care appointments showed people access a range of community based services, including doctors, district nurses, opticians, dentist, speech and language therapist and dietitian. The temporary manager said she felt staff responded well in meeting peoples health needs. Staff spoke of ways they promote peoples well being and gave examples of regularly cleaning peoples glasses and dentures, checking hearing aids are in working order and discussing any health concerns with family members. Staff were seen cleaning peoples glasses during the visit. One person spoke of hurting her finger and the doctor coming to look at it. Another person said she felt that not all staff fully understand her healthcare needs. One person has been assessed as being able to self medicate and nurses give out medication to the others. There were suitable storage arrangements and accurate records made of medication administered, although two entries in the controlled drugs register were unclear. Staff were able to describe good practices in administering medication and one person said, I get what I need, if I am in a lot of pain they give me some painkillers. Staff were seen talking in a relaxed and friendly way with people in the home and were joking and laughing. There were references in care plans to promoting peoples privacy and dignity, including peoples preferences. Staff said they have discussed in training ways of promoting peoples privacy and dignity, and gave examples of how they do so. One person said that when she first came to the home people were trying to help her with dressing but she does as much as she can for herself. Care Homes for Older People Page 14 of 26 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. People have opportunities to take part in activities both in and out of the home. There are opportunities for people to exercise choice in their lives, and they are provided with a wholesome diet. Evidence: There is an activities coordinator employed for four sessions a week who said she spends time with people confined to bed as well as those in the lounges. During this visit the activities coordinator spent time talking with people and asking what they would like to do, who requested a game of play your cards right. A record is made of any social activity in the care file and these showed that regular activities are taking place, including dominoes, I spy, card games, skittles, sing a longs and reminiscing. One person mentioned she had several friends and families birthdays coming up and a member of staff asked her if she needed to get any birthday cards. Staff said the activities coordinator does a lot with people and they will also do things, Care Homes for Older People Page 15 of 26 Evidence: including taking people out shopping. Comments made included, some staff will go shopping for us and I join in most things. When Mr Motivator comes I try to do as much as I can. Staff said they will take people into town for a coffee or tea. One person said she had suggested going to the garden centre for a coffee and cream cake. Staff spoke of providing people with choices about their daily routines, such as when they get up and go to bed, what they wear and what activities they take part in. People were seen using various areas of the home, and some people were joining in activities and others not. There was a choice of fruit or biscuits with the mid morning drink. One care file showed one person had chosen to stop going to physiotherapy. One person said, I have got used to the time to come down, you have to have a set time for breakfast, that happens even in a hotel. I dont like the light going on and getting up straight away though. There is a four week menu which includes a roast dinner on Sundays and a fish dish on Fridays. The main meal is had at lunchtime and dishes include, pies, chicken kiev and liver and onions. A lighter meal is had at tea time and dishes include fish fingers, waffles, crumpets and boiled eggs. There is a pudding provided at lunch and tea time. The temporary manager said they have introduced two lunchtime sittings so that people who require assistance in eating their meals can be assisted in a more relaxed manner. People commented that the food is very good and they have more than enough. One person said, I was in hospital for 14 months and did not have a piece of salmon. When I mentioned it they gave me some. Another person said, I would like a jacket potato sometimes. Care Homes for Older People Page 16 of 26 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. People feel that if they had cause for concern this would be dealt with seriously and they feel safe in the home Evidence: The temporary manager said she had just dealt with a complaint about some missing glasses and clothing. As a result the glasses had been replaced. This was recorded in the complaints book. There were not any other complaints recorded. Staff were aware of the complaints procedure and one person said, If I mention something they try to do something about it and another said, If I had any serious questions I could ask the owners, they are easy to talk to. The temporary manager said training on safeguarding adults has been arranged, but could not find the most recent Nottingham and Nottinghamshire safeguarding adults procedures. The provider took the details to obtain a copy. There have not been any safeguarding referrals made. Staff said safeguarding adults had been included in training they have had and a course has been arranged. They were also aware of the policy on whistleblowing. People spoke with said they felt safe in the home. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 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 a comfortable and well maintained environment. Evidence: Areas of the home visited were clean, tidy and in good repair. A handyman is employed in the home, who is also responsible for maintaining the grounds. One of the communal areas has been extended and a hairdressing salon added since our last visit. One person said, The home is very comfortable and One of the night staff bought me down a chair that she thought would be more suitable for me. Staff were seen using protective clothing and there are systems in place for waste disposal and washing any soiled laundry. Staff have had training in infection control. Care Homes for Older People Page 19 of 26 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. There are sufficient and suitably trained staff on duty. Evidence: There are three care staff and a nurse on the late shift and two care staff and a nurse overnight. Staff and people living in then home felt this was sufficient. Information included on the Annual Quality Assurance Assessment showed that staff have achieved a professional qualification (National Vocational Qualification level 2 or higher) . A sample of staff files were seen and these contained the correct recruitment checks and information, although there was not a full history of previous employment Staff training records showed that regular training is provided and the temporary manager said all mandatory training is kept up to date. Staff said recent training they have had includes moving and handling and caring for people with dementia. One person said, I think they are well trained. Care Homes for Older People Page 20 of 26 Care Homes for Older People Page 21 of 26 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. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The temporary manager was able to answer all questions put to her as part of the inspection and provided the required documentation. People living in the home were seen speaking to the temporary manager as the person in charge. The provider showed a quality assurance questionnaire they use to seek peoples views about the home, but said he was looking to change this. The temporary manager said she had given a couple out to visitors last week. A sample of completed questionnaires were seen which reflected positively about the home. Care Homes for Older People Page 22 of 26 Evidence: There is a relatives and residents committee where people can put forward any suggestions and comment on the home. There is a system for people to have assistance in managing their personal allowances. The records kept of transactions made were seen and these were signed and witnessed and where possible receipts are kept. It was stated on the Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other regulatory body. The fire safety records were seen and these showed the required tests are carried out at the correct frequency. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 29 19 A full previous employment history must be obtained on all new staff. This will ensure people are cared for by people who have been fully vetted. 01/03/2009 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 14 People should be able to wake and get up in a manner they choose. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. 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!