Inspection on 28/01/09 for Ayrshire House
Also see our care home review for Ayrshire House for more information
This is the latest available inspection report for this service, carried out on 28th January 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.
Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Ayrshire House 24-26 Main Road Long Bennington Newark Notts NG23 5EH 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: Alison Jessop
Date: 2 8 0 1 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (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 Adults (18-65 years) Page 3 of 25 Information about the care home
Name of care home: Address: Ayrshire House 24-26 Main Road Long Bennington Newark Notts NG23 5EH 01400281971 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : sazwright@totalise.co.uk Ms Sarah Wright care home 15 Number of places (if applicable): Under 65 Over 65 3 learning disability Additional conditions: Date of last inspection Brief description of the care home 12 Ayrshire House is a listed Georgian building with a large garden, situated on the main road running through the village of Long Bennington and in close proximity to the village shops and pubs. There is a church, a village hall and a medical centre and the home has a mini-bus to provide transport for residents, Newark and Grantham being approximately 5 and 8 miles away. The home is registered to provide care and accommodation for up to 15 residents with a defined mental health need, three of these being over 65 years, in two shared and eleven single rooms, on three floors. A copy of the Service User Guide and Statement of Purpose can be obtained from the manager. Care Homes for Adults (18-65 years) Page 4 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and formed part of a key inspection, focusing on key standards, which have the potential to affect the health and welfare of people who use the service. Throughout this report the terms we and us refers to The Commission for Social Care Inspection (CSCI). The visit lasted approximately 2.5 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 that 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. Care Homes for Adults (18-65 years)
Page 5 of 25 The main method used to carry out our inspection is called case tracking, this includes following the care of a sample of two people through their care records and assessing their care. We spoke to two people and saw the bedrooms of those who said we could. We also spoke with two staff. The registered provider was present throughout the inspection and feedback was provided at the end of the visit. 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 –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings
Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 service has a robust admission procedure which would be used should a vacancy arise and would ensure that the persons needs can be met. Evidence: All of the residents who live at Ayreshire House have done so for many years, therefore no new admissions have been made. We saw that each resident has a care plan, which includes information gained during the initial assessment process. The provider told us that the admission procedure would be followed if a vacancy arose in the future, where peoples needs would be fully assessed prior to agreeing admission to the home. The Annual Quality Assurance Assessment (AQAA), which is a self assessment completed by the manager said all service users undergo an in depth assessment process, which includes care plans, risk assessments and personal history. This is reviewed annually or sooner if needed. We looked at the care plans of the residents and confirmed that these are reviewed. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices
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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 people who live in the home are encouraged to make decisions about their lives with the assistance from staff, this promotes their independence in a risk managed way. Evidence: We looked closely at the care plans for two residents. We saw that both care plans had been regularly reviewed with the involvement of the resident and other people such as relatives, social workers and day care services. Each plan contained information on the residents health, social, leisure and educational needs. Specialist health care support plans were also in place for people who have specialist needs. There was also a pen picture of each persons life history and personal preferences and choices. One resident said I like to go out now and again to the pub but I prefer to go to the one at the other end of the village. We usually decided what we want to do. The staff have not yet included information on the Mental Capacity Act. This is new legislation that protects the rights of people living in the home.
Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Risk assessments had been completed which also reflected where people take risks how these risks will be managed. Close monitoring of the person had been recorded and the records demonstrated how people make choices. The staff said one resident does not like to go out at all, and becomes upset if we try to take her out of the home, so we just let her stay here now where she is happy and this prevents her becoming distressed. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle
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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 residents clearly enjoy feeling part of the local community and are fully supported by the staff to maintain their independence. Evidence: We spoke to two residents who live at the home. They both said that they go out and attend various clubs and make use of the community facilities. One resident said I go out to a club today, I meet up with other people and we play Bingo and chat. I really enjoy it. Another resident said we go out shopping and to the pub for meals. Residents are encouraged to participate in running the household and carry out household chores in order to promote their independence. One resident said I like to wash the cups up after tea and I keep my bedroom clean and tidy. Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: Two of the residents living at the home do voluntary work in charity shops and most of the residents go to college or day care. Feedback about the food was good. One resident said yes we get some nice meals and we get to choose what we want to eat. The residents were observed enjoying lunch and said that they are involved in planning the menus and food preparation. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support
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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. The residents receive care and support in a dignified, caring manner. Residents health care is closely monitored to ensure their well being. Evidence: The two residents spoken to said that staff treat them in a dignified manner. One resident said yes, the staff are very kind to me, they look after us very well. Each resident has a health care plan which reflects the health and personal care needs of each resident. We saw that the health care needs of each person is closely monitored and recorded. Specialist health care needs have a separate plan with procedures to follow such as for one resident who requires Stoma Care. Residents spoken to said that they can see the doctor if they need to, they attend the local GP surgery in the village. Residents daily notes also showed us that they receive other services such as dentists, opticians, well woman and well man services, chiropody and hearing services. Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: We looked at the medication records for two residents. These were satisfactorily maintained. The medication was stored securely and staff have received training to be able to administer medication in line with policies and procedures. The pharmacist carries out regular audits to ensure that medication procedures are being followed. There were no issues identified. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 people who live in the home live in a safe environment where they can be assured that staff will deal with any concerns they have. Residents are protected by the robust safeguarding procedures. Evidence: The provider stated that the service has not received any complaints in the last twelve months. Two residents spoken to said that they would speak to a member of staff or the manager if they had any concerns. CSCI has not received any complaints about this service in the last twelve months. There has not been any adult safeguarding investigations in the last twelve months. Staff that were spoken to said they are aware of the procedures to follow should they suspect that abuse has taken place. Care Homes for Adults (18-65 years) Page 16 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Ayreshire House provides a warm, comfortable and homely atmosphere to the residents who live there. Evidence: Ayreshire House provides residents with well maintained communal and private space. The lounge and dining room are nicely decorated and furnished. Two residents were happy to show us their bedrooms. They were attractively decorated and filled with personal items to make them feel homely. The residents are involved in keeping the home clean and tidy, particularly their bedrooms with support from the staff. The kitchen is a very large bright area with a large farmers kitchen table where the residents can eat together. There is also a large activities room where residents can enjoy social activities and entertainment. There is a very large garden at the side and back of the home which contains seating areas and a vegetable patch for the residents to grow their own vegetables. The home looked very clean throughout and the manager has recently attended a training course on Infection control which she filtered down to the other staff working at the home.
Care Homes for Adults (18-65 years) Page 17 of 25 Care Homes for Adults (18-65 years) 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 stable, skilled and dedicated staffing team, ensures that residents receive good quality, continuous care. Evidence: The Annual Quality Assurance Assessment told us that 80 of staff working at the service have an National Vocational Qualification (NVQ). During the visit the provider told us that two staff are currently completing an NVQ course and two senior staff are attending a course for Team Leaders. The feedback from the residents about the staff was good. One resident said I think the staff are great, they really do help me. Since the last inspection staff have completed a lot of training including health and safety, fire safety, infection control, adult safeguarding, risk management, food hygiene and distance learning. We gained feedback from two staff. One said we have all worked here for so many years, we all know the residents needs really well. We are like one big happy family really.
Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: We looked at the recruitment records for two staff. Two satisfactory references and an enhanced criminal record disclosure had been received prior to working with the residents. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is owned and managed by competent, caring people who ensure that the residents safety and well being is paramount. Evidence: The provider has owned and worked in the home for 17 years. She is very involved in the day to day care of the residents and keeps her skills and knowledge up to date. The provider and registered manager have attended a training course on new legislation called the Mental Capacity Act. This Act protects peoples rights and gives them freedom to make choices but also protects them when they are unable to make choices due to their incapacity. Residents views are listened to in different ways. Each resident has a key worker who provides more one to one support in matters about that person. Residents meetings are held on a regular basis where the residents can discuss ideas, concerns and plans for the future. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The staff have regular meetings which includes meetings with day care services. This ensures that communication is good between all parties involved in the residents care. Regular health and safety audits are carried out by the staff and the manager of the service. The fire safety inspections are carried out regularly and we saw that policies and procedures are reviewed regularly. There have not been any reportable incidents since the previous inspection. The contact numbers and addresses of CSCI were out of date which would have meant that staff may have sent information to the wrong place. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 7 Staff need to show/record evidence that the residents mental capacity has been considered when reviewing their care. The manager should ensure that staff have access to the correct contact details of the CSCI at all times. 2 37 Care Homes for Adults (18-65 years) Page 24 of 25 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 Adults (18-65 years) 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!