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Inspection on 26/07/10 for Ashwood Lodge Care Home

Also see our care home review for Ashwood Lodge Care Home for more information

This is the latest available inspection report for this service, carried out on 26th July 2010.

CQC found this care home to be providing an Poor 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.

What the care home does well

The newly reviewed care records and much more informative and person centred. A new manager has been appointed who is providing clear leadership to the service. Staff enjoy working at Ashwood Lodge and have commented positively about the new manager and also about the additional opportunities for people living at the home to go out.

What the care home could do better:

There is the need to continue to roll out the staff training, including moving and handling training and dementia care training. Formal staff supervision needs to continue and needs to include all staff. The work that has commenced on reviewing and updating care plans should be completed. The skill mix of staff needs to be reviewed and there needs to be sufficient senior staff cover for all eventualities. It is recommended that the service look to developing some succession planning within the senior staff team, this will provide additional support and flexibility to the management of the service. The refurbishment and redecoration that is needed in respect of the bathrooms, showers and toilet needs to take place.

Random inspection report Care homes for older people Name: Address: Ashwood Lodge Care Home Bedale Avenue Billingham Cleveland TS23 1AW zero star poor service 10/05/2010 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: Jacqueline Herring Date: 2 6 0 7 2 0 1 0 Information about the care home Name of care home: Address: Ashwood Lodge Care Home Bedale Avenue Billingham Cleveland TS23 1AW 01642361122 01642363710 ashwoodlodge@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Nationwide Healthcare Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 27 Number of places (if applicable): Under 65 Over 65 0 27 dementia old age, not falling within any other category Conditions of registration: 27 0 The maximum number of service users who can be accommodated is 27 The registered person may provide the following category of service only: Care Home only - Code PC, to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number 27 Dementia, Code DE, maximum number 27 Date of last inspection 1 0 0 5 2 0 1 0 Care Homes for Older People Page 2 of 11 Brief description of the care home Ashwood Lodge is a 27 bedded care home registered to provide care to older people for personal care and people with dementia. The home is situated in a residential area of Billingham. All rooms used and occupied by the residents are on the ground floor. The home provides both single and shared bedroom accommodation. Two of the bedrooms have en suite toilet facilities. Both lounge and dining areas are provided for those residents who wish to socialise. The home provides car-parking facilities for visitors. Care Homes for Older People Page 3 of 11 What we found: This inspection at Ashwood Lodge was unannounced and was conducted on 26 July 2010. It was completed in one day by by one compliance inspector. The purpose of this inspection was to check for compliance in respect of a warning letter that had been sent to the provider. The warning letter detailed breaches of regulations in respect of safety for people within the environment, staff training and induction and regulation 26 visits by the provider. Prior to this compliance inspection and following the Key Inspection, we met with the providers of the service. This meeting was to discuss our concerns and to discuss directly with them our expectation about their roles, responsibilities and their compliance with legislation. During this inspection we looked at staff training records, staff supervison records and staff recruitment records for induction purpose. We also had a look around the home and checked health and safety records. Discussion took place with the manager about staff training in regard to whistleblowing and protection of vulnerable adults. The manager had tried to access external courses but these are not available until November 2010. She has in the meantime delivered some in house training, staff have completed the Adult Protection level one workbook which the manager has checked and when satisfied with level of completion and understanding has issued an in house certificate. The manager said that the majority of staff have now completed this, and this was evidenced on the training matrix. Copies of the completed workbooks and certificates were also made available. Staff who were spoken to also confirmed that they had completed this training and workbook recently. We had a look around the home and checked that the areas identified as potential risk at the last key inspection had been attended to. Rooms that people living at the home should not have access to now have keypad locks fitted to them. Care is however needed as the laundry door was closed by the keypad had been disarmed. This was discussed with the laundry person who said they had done this and would not do so again. The room that is used for ironing has a bolt fitted to the outside. The manager confirmed that they would replace this with a keypad. Maintenance records were looked at. Weekly fire alarms checks are now being carried out and the water temperatures to areas that people living at the home have access are now being checked and recorded weekly. Toilet, bathroom and shower doors now have locks fitted and it was previously confirmed that a small number of windows that were not restricted have been. Unused bedrooms that had been used for storage purposes have been cleared and a number of these bedrooms have been improved and made more welcoming. Training was discussed with the manager and there was a training matrix and training Care Homes for Older People Page 4 of 11 statistics in place. The manager also has developed individual training records. Staff have recently completed Mental Capacity Act and Deprivation of Liberties training along with fire and food hygiene. Moving and handling training is planned and the manager is to facilitate this. Staff spoken to confirmed they had received this recent training and copies of certificates were looked at, which also confirmed this. Although all training is not fully up to date, the manager has made significant progress in updating records to establish an accurate assessment of staff training needs within Ashwood Lodge. She is well aware of the training needed and is making good progress in ensuring that this takes place. Regulation 26 visits are now taking place and a copy of the June visit was looked at. The report referred to actions needed for improvement and development. The manager said she produces a monthly managers report and the providers use this as part of of monitoring progress. Action plans were also observed, which had clear outcomes and timescales. The training matrix was looked at and it was identified that fourteen of the twenty-one staff were up to date with first aid training. All senior carers are first aid trained and the manager confirmed that there is always a first aider on duty. Copies of first aid certificates were observed in the training files looked at. Seventy five per cent of care staff are qualified to NVQ Level Two in Care or above. Further staff have commenced this qualification. Requirements made at the last Key Inspection were also looked at during this visit. A new manager has been appointed and has commenced employment since the key inspection. They are in the process of registering with CQC. Discussion took place about the structure and management arrangements within the service. It is recommended that consideration should take place in respect of personal development and succession planning within the senior staff team, which will give additonal management cover should it be needed. The care files for people living at the home were discussed with the manager who said that she commenced an audit of them and after auditing five had made a decision with the senior carers that they should all be rewritten. She said that so far, approximately seventy per cent had been completed, although there was still some development to do and some additional staff learning. The care file of one person was looked at and there was a good assessment of need in place along with a range of assessment tools. Care plans had been developed for areas of need and where necessary were supported by additional risk assessments. The care plans were very well written, person centred and gave staff the information they needed to meet this persons need. Plans of care were also in place for this persons mental health needs. A further two care files briefly looked at and as identified by the manager some additional development was needed within some of the care plans to increase the level of detail. Care Homes for Older People Page 5 of 11 The manager had also put an information file together for staff to use as guidance for completing peoples care needs assessments and developing care plans. The systems for recording accidents and incidents has been reviewed since the last inspection. The manager is now looking at these on a daily basis and has introduced monthly audits along with additional accident/incident reporting and investigation should this be necessary. Evidence of this was seen within the accident and incident file. During this inspection an area identified in need of review and action is in relation to the skill mix of staff within Ashwood Lodge as there is a shortage of Senior Carers. The manager confirmed that they are recruiting, with no success. Whilst shifts are in the main being covered by Senior Carers, currently three to cover twenty four hours per day, seven days per week, there is no flexibility and staff are having to work additional hours to provide this cover. Additionally there have been times on night duty when there has not been a Senior Carer and although arrangement have been in place to ensure people have their medication, in the event they needed further medication through the night, this would cause some difficulty. The manager and two Senior Carers do cover an on call system however this is not wholly suitable or practical. A recommendation was made at the last inspection in respect of the need to refurbish and redecorate the bathrooms/showers and toilet. This work is yet to take place although the manager did confirm that approval had been given for redecoration. What the care home does well: What they could do better: There is the need to continue to roll out the staff training, including moving and handling training and dementia care training. Formal staff supervision needs to continue and needs to include all staff. The work that has commenced on reviewing and updating care plans should be completed. The skill mix of staff needs to be reviewed and there needs to be sufficient senior staff cover for all eventualities. It is recommended that the service look to developing some succession planning within Care Homes for Older People Page 6 of 11 the senior staff team, this will provide additional support and flexibility to the management of the service. The refurbishment and redecoration that is needed in respect of the bathrooms, showers and toilet needs to take place. 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 21 23 The bathrooms, shower and toilet must be refurbished, redecorated and thoroughly cleaned. This will ensure that these environments are more conducive and pleasing for people to use. 03/09/2010 2 27 18 The current skill mix must be 17/09/2010 reviewed and there must be sufficient senior staff employed. This will ensure that people living at the home receive the care they need at all times by appropriately qualified staff and that there is sufficient staff in the event of annual leave, sickness and absence. 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 work that has commenced on reviewing and updating peoples assessments of need and plans of care should be completed. The planned external training in respect of Protection of Vulnerable Adults should take place. The planned moving and handling training should take place as should further dementia care training. Consideration should be given to developing some succession planning within the senior staff team, this will provide additional support and flexibility to the management of the service. The formal supervision that has commenced should continue and all staff should receive formal supervision every six weeks. 2 3 4 18 30 32 5 36 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. 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