Inspection on 04/02/10 for Ashfield Lodge

This is the latest available inspection report for this service, carried out on 4th February 2010.

CQC found this care home to be providing an Excellent 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

Ashfield Lodge 23/02/06

Ashfield Lodge 06/07/05

Ashfield Lodge 25/10/04

Ashfield Lodge 07/06/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Key inspection report Care homes for older people Name: Address: Ashfield Lodge Ashfield Road Sleaford Lincolnshire NG34 7DZ     The quality rating for this care home is:   three star excellent 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: Alison Jessop     Date: 0 4 0 2 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Ashfield Lodge Ashfield Road Sleaford Lincolnshire NG34 7DZ 01529307330 01529414420 ashfield.lodge@craegmoor.co.uk www.craegmoor.co.uk Health & Care Services (UK) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Ashfield Lodge provides nursing care for up to 20 residents who have a dementia and or mental health problems. The home is a single storey purpose built facility close to the centre of the town of Sleaford. Accommodation is provided in single bedrooms each with en-suite facilities. There are also 2 lounge/dining rooms and an enclosed garden area with seating and plants, which are accessible by residents. The home is within walking distance of local amenities, such as shops, newsagents, hairdressers etc. There are car-parking facilities at the front of the home. The home provides transport for the residents to enable them to use local facilities. Ashfield Lodge also provides day care services however this is not registered with CQC and therefore not subject to inspection or regulation. Care Homes for Older People Page 4 of 25 Over 65 14 4 1 1 Brief description of the care home The current fees for the home range from £649 to £695. This does not include chiropody, hairdressing and toiletries. A list of prices for these extra services can be obtained from the manager. A copy of the service user guide and statement of purpose can also be obtained from the manager. Care Homes for Older People Page 5 of 25 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: three star excellent 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: This was an unannounced visit which formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of the people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission. The visit lasted approximately six hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting the standards and their plans to improve aspects of the service. We also sent out surveys to a sample of residents, staff and health care professionals. The feedback we gained is included in this report. Care Homes for Older People Page 6 of 25 The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of three people through their care records and assessing their care. We spoke to four people who use the service, two relatives and three members of staff. The Registered Manager was present throughout the visit and the general outcomes of the visit were discussed with them. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 25 We did not make any requirements or recommendations as the outcome of the inspection was excellent. 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 9 of 25 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 25 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. The home has a robust admission procedure. Evidence: The manager or deputy manager carry out a personal assessment when people are referred so that they can make sure that peoples needs can be met. We looked at the care plans of three residents and saw that comprehensive information had been gained about the person. This information then formed part of the on-going care plan. The care plan also explains the reason for the persons admission to the service. The Annual Quality Assurance Assessment told us that the manager gives each new resident a list of extra fees for services that are not included in the weekly fees. This is then signed by both the resident and/or their representative. Care Homes for Older People Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive excellent, personalised care where their dignity is respected. Evidence: We looked at a sample of care plans and saw that each person had a comprehensive assessment of their needs, where the information gathered had been included in the plan of care. Each care plan was person centred and included a statement on the reason for my admission and people who are important to me. The care plan also included a statement on personal goals, aspirations, outcomes, likes and dislikes, what I can do for myself and what I need help with. Each care plan had been regularly reviewed. The care plan included details on the the needs of a persons safety, mobility, personal hygiene, skin care, pressure sore care and prevention, eating and drinking, falls, breathing, continence, sleep, pain, circulation, mental health, finances, social and religious needs and medication. An individual fire risk assessment and emergency evacuation plan had also been completed and stored at the front of each file for easy access. Care Homes for Older People Page 12 of 25 Evidence: We saw that comprehensive daily notes had been made about the care that people had received and also nutritional monitoring and turning had been recorded for people who were considered to be at risk or who are receiving bed care. Feedback about the care was excellent one person said Its the best nursing home I have ever been in, much better than where I lived before. The staff are very nice to me, they treat me with dignity and respect. A relative said They always let me know when my relative is unwell, they provide care that is excellent and always look after him really well. Another relative said kindness and consideration is given to all the patients. My relative is given wonderful care. They are there to attend to his needs and everyone is very supportive towards me. Everyone that we spoke with confirmed that they are treated with dignity and respect. The manager told us that the home is holding a dignity in action day in February in order to promote the dignity of people who receive care. We looked at the medication procedures and did not identify any issues. The majority of medication is provided by the Pilgrim Hospital pharmacy and along side internal medication audits, the pharmacy undertake monthly medication audits in the home. The last audit was undertaken on the 23/01/10 and the outcome was that 94 of standards had been met. Care Homes for Older People Page 13 of 25 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 access to various stimulating activities however more could be done to stimulate people on an individual basis. Evidence: We spoke with the service users who told us we do lots of activities like dominoes, we play games which help us keep fit, we have visits from the minister from church. We do lots of different things which keep us occupied. The manager showed us the memory lane which residents can walk down and look at all the pictures of things that remind them of the past. The activity timetable was on the wall in the lounge which showed table games, discussion, reminiscence, card games, sing along, bingo, hand massage, personal choice, walks, out for coffee. Day trips are organised by staff and a trip to Skegness was being arranged. We didnt see that staff interacted with people on a one to one basis very much and people were not given occupational activities to do. The manager said that they have done some work on this but more is planned. The care plans include information on peoples life history and their likes and dislikes and personal preferences. One relative said it would be nice to see more one to one time spent with the people who dont go Care Homes for Older People Page 14 of 25 Evidence: into the lounge. The menu was displayed on the wall in the lounge. People said that they are given plenty of choice. One person said the food is very nice, especially the breakfast. Another said I get to choose what I eat, its all very good. We spoke with the chef who said that he goes to people each day and asks them what they would like to eat that day. If they dont like whats on the menu then an alternative is available. Care Homes for Older People Page 15 of 25 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. The service has a robust complaint procedure and people are protected by the thorough recruitment procedures. Evidence: A copy of the complaint procedure is displayed in the reception area and a copy is also included in the service users guide. People that we spoke with said that if they had any concerns they would speak to a member of the staffing team or the manager. The manager reported that the home has not received any complaints in the last 12 months. No complaints have been made to CQC about the service since the last inspection. We spoke with staff who told us that they are fully aware of the Adult Safeguarding Procedures and Whistle Blowing procedure. A copy of these procedures is maintained in the reception area. We saw that staff receive training each year to ensure that they have current and up to date information. There has not been any adult safeguarding allegations made about this service and their has not been any investigations. Recruitment procedures ensure that people are vetted prior to commencing employment in the home. We saw that assessments had been completed to ensure that peoples rights and choices are respected in accordance with new legislation called the Mental Capacity Care Homes for Older People Page 16 of 25 Evidence: Act and Deprivation of Liberty Safeguards. Care Homes for Older People Page 17 of 25 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. Ashfield Lodge provides a clean, comfortable and homely environment to the people who live there. Evidence: The home is purpose built and single storey with lots of spacious communal internal and external areas. New equipment has been provided such as profiling beds, new bedding and curtains. There is a sensory garden at the back of the home which is fully accessible. Each bedroom has been individually decorated and contained peoples personal items which made the bedrooms look homely. The people we spoke with told us that they are happy with the environment and that they felt at home. One relative said my husbands bedroom has been redecorated and they are providing new carpet for him. The staff are happy for me to make the room look more personalised and have put up a TV on his wall which can be viewed from the bed. The bedroom is kept nice and clean and the bedlinen is changed regularly. Communal areas looked clean and tidy and a cleaning schedule is in place to ensure that the home is kept clean and hygienic. We saw that staff wore protective clothing and had received training in infection control procedures. Care Homes for Older People Page 18 of 25 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 service is provided by a caring team of staff that are well trained. Evidence: We spoke with three staff who told us that they receive a lot of training and support. Many of the staff have worked at the home for several years and said that the team work well together. On each shift there is a qualified nurse and a team of carers and domestic staff. There is a bank staffing list to cover for annual leave and sickness. We looked at the staff training records of two staff. We saw that they had completed training on moving and handling, fire safety, health and safety, food hygiene, first aid, safeguarding adults, infection control, equality and diversity, prevention of primary aggression and dementia awareness. The trained nurses had also completed refresher courses on medication and pressure sore prevention and care. We saw that all new staff receive an induction which includes the Skills for Care Common Induction Standards. We also saw that staff competency has been assessed before working with service users. We looked at the staff recruitment files for two new staff. On the staff recruitment file we saw an application form, two satisfactory references, one which was from the persons previous employer, a criminal record disclosure and for nurses a copy of their Care Homes for Older People Page 19 of 25 Evidence: Nursing and Midwifery PIN number. We also saw that a certificate of naturalisation had been gained for overseas employees. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and comprehensive quality auditing processes in place. Evidence: The registered manager is a qualified nurse and has gained her registered Managers Award level 4. Staff said that the manager is very supportive and approachable. A relative said the manager is great, I can talk to her about anything and I feel she always listens and acts on what she says. The manager told us that the home had recently won the Craegmoor Leading Lights Award for 2009. We saw that the service has comprehensive quality assurance auditing processes. We saw that regular quality audits had been carried out by the companies quality auditing team and clinical governance team. The audits are unannounced and the outcomes for the majority of audits was excellent. We saw that audits had been carried out on medication, finances, equipment, fire safety, health and safety, evacuation plans, accidents, weight loss, pressure sores, food safety pest control and vehicle checks. Care Homes for Older People Page 21 of 25 Evidence: The company sends out quality monitoring surveys which are analysed by the internal auditor and a report sent to the service to act on any issues. The home holds a your voice meeting, which involves service users and their relatives/representatives. This encourages people to raise opinions and views about the service. We saw that peoples personal finances can be stored securely in the office if they choose to do so. Records are maintained of all transactions and a financial audit is carried out by external auditors every six months. We saw that health and safety checks are carried out and their is a health and safety committee who review health and safety polices and procedures. We saw that equipment is regularly tested and risk assessments are regularly reviewed. All accidents and incidents had been recorded each month and the quality auditors and clinical governance team look for any trends in order to prevent further incidents. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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 non-commercial 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 25 of 25 - 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!