CARE HOMES FOR OLDER PEOPLE
Ascot Nursing Home 19-21 The Crescent Linthorpe Middlesbrough TS5 6SG Lead Inspector
Joanna White Unannounced Inspection 15th December 2005 11:15 X10015.doc Version 1.40 Page 1 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 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ascot Nursing Home Address 19-21 The Crescent Linthorpe Middlesbrough TS5 6SG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01642 825283 01642 850412 Mr George Dixon Mrs Susan Olive Ellis, Mrs Angela Catherine Allick, Mr Michael Dixon Mrs Helen Hutton Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: Ascot is a care home providing both nursing and personal care for older people. It is a three-storey building providing single and double accommodation for 32 Residents; the 30 single bedrooms are a minimum of 10 sq.m. and the 1 double bedroom is a minimum of 16 sq.m. There is a passenger lift giving access to the upper floors. There is one large lounge and one communal dining room. The home is close to local shops and amenities with a small area for parking at the front of the home. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection commenced at 11. 15 a.m. and concluded at 16.30 pm. Three Residents, four visitors and four members of staff were spoken to during the inspection. What the service does well: What has improved since the last inspection?
Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 6 A new industrial drier had been bought for the laundry. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1-5 were not assessed during this inspection. applicable. Standard 6 is not EVIDENCE: Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 There are no residents currently responsible for their own medication. Policies and Procedures are in place for the receipt, recording, storage, handling, administration and disposal of medicines. EVIDENCE: On the day of the inspection the homes Policies and Procedures for the receipt, recording, storage, handling, administration and disposal of medicines were audited. There was evidence that training is provided for care staff. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Residents find the lifestyle experienced in the home matches their expectations and preferences regarding their social, cultural, religious and recreational interests and needs. EVIDENCE: During a tour of the home the inspectors observed photographs of the residents involved in activities. There was also a chart on the wall, which gave information about the activities, which were planned for the next year and which will be managed by an activity organiser who is employed by the home. One resident who had sight difficulties was reading a brail magazine. There was also evidence the home was preparing for Christmas. The residents who spoke to the inspectors confirmed they could choose whether or not they wanted to participate in the activities, which included bingo, making cards and playing skittles. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The registered person ensures that written policies and procedures are in place to safeguard the residents in the home. EVIDENCE: An Adult Protection and Prevention of Abuse Policy was available which included reference to the Teesside Inter- Agency Policy Procedures and Practice Guidance- No Secrets-Protecting Vulnerable Adults from Abuse. There was evidence of appropriate training being provided and staff who spoke to the inspectors confirmed they understood the procedures to follow should they have any concern about the welfare of a resident within the home. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 The residents live in a comfortable, homely, accessible and well-maintained environment, which meets their individual and collective needs. EVIDENCE: On the day of the inspection the maintenance records were audited. The central heating boiler had been replaced. There was a plan in place to renew the hall carpet. A new industrial drier for the laundry had been purchased, and a new carpet was observed in one of the bedrooms. There was evidence a new monthly monitoring form had been introduced for bed rail inspections and was in the process of being implemented. There was also evidence the home complied with the requirements of the local fire service and environmental health department. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 13 The resident’s bedrooms were comfortable and individually decorated with personal belongings, which included fridges, chairs, furniture, pot plants, flowers and telephones. There were also facilities for a husband and wife to share accommodation. Toilet and bathing facilities were warm, clean and hygienic and met the needs of the residents. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 Staff are being trained to NVQ level 2 which will ensure that they shall meet the needs of residents. EVIDENCE: It was recorded in the Pre-Inspection Questionnaire that 61 of staff had been successful in obtaining their NVQ Level 2. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The registered manger ensures as far as reasonably practicable the health safety and welfare of service users and staff. EVIDENCE: The inspectors audited the homes Health and Safety Policies and Procedures. On the day of the inspection the laundry area was observed to be a safe environment, clean and well managed. Staff have received health and safety training e.g. Manual Handling and Fire training. Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ascot Nursing Home DS0000061594.V258833.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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