Inspection on 04/05/05 for Ascot Nursing Home

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Ascot Nursing Home 19/09/07

Ascot Nursing Home 02/05/06

Ascot Nursing Home 18/10/05

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Fountain View

Wardington House Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE ASCOT NURSING HOME Burleigh Road Ascot Berks SL5 7LD Lead Inspector Mrs Rhian Williams-Flew Unannounced 4 May 2005 Time: 09:25 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 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 and Care Homes for Adults 18 – 65*. 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 H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ascot Nursing Home Address Burleigh Road, Ascot, Berkshire, SL5 7LD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01344 620656 01344 621606 robertsonhomes@ukonline.co.uk Ascot Nursing Home Ltd, Burleigh Road, Ascot, Berkshire SL5 7LD Mrs Jill Chufungleung Care Home 72 Category(ies) of Dementia (15), Dementia - over 65 years of age registration, with number (29), Mental disorder, excluding learning of places disability or dementia (22), Mental Disorder, excluding disablity or dementia - over 65 years of age (26) ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection First Inspection following registration on 12.1.05 Brief Description of the Service: Ascot Nursing Home is an Edwardian house with a purpose-built extension set in its own grounds close to Ascot village and Ascot racecourse. The home is registered to provide nursing care for up to 72 people of both sexes who have mental health needs. The home is registered to take people who suffer from dementia either in older age or under 65 years of age. Also, people who suffer from a mental disorder either in older age or under 65 years of age. The home is divided into three units. Each unit functions independently with unit offices, dining rooms, sitting rooms and distinctive staff teams. Unit one cares for residents of all ages who have been diagnosed as suffering from moderate to severe dementia. Unit two cares for older residents who have in enduring mental health needs. These residents may also need some physical assistance. Wrens unit cares for residents with enduring mental health needs who are generally able to maintain their own physical care with support and encouragement. Mrs Jill Chu, the Registered Manager, is responsible for the overall management of the Units and the care home. This information has been taken from the homes Statement of Purpose. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection occurring on a weekday between 9:25 hours and 18:50 hours. The Registered Manager was present throughout the inspection and the Responsible Individual visited the home during the day. A tour of the premises to include all three units was undertaken. The primary focus of the inspection occurred in Units one and two where 8 residents and 1 relative were spoken with to find out their views about the care they receive at the home. 6 other residents were observed however, due to the progress of their dementia they were unable to converse. 6 care plans were reviewed from this total of 14 residents. This enabled the Inspector to case track the observations made on the day with the recorded care plan. Some staff members were also spoken with. A Pharmacist Inspector conducted an inspection of the storage and administration of medicines in the home. What the service does well: What has improved since the last inspection? Since the pre-registration visit in September 2004 the priority areas for refurbishment in the home have been completed. This has greatly improved these areas of the home. The home has also developed a three-year ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 6 refurbishment/decoration plan that is proving to be successful. The Responsible Individual has given his financial commitment to the plan. 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 H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) (OP) 1,2 3,4 and 5. 6 is not applicable. (A 18-65) 1 and 5 This home provides good information for prospective residents and their relatives. All prospective residents are assessed by the Registered Manager to ensure that their care needs can be met. EVIDENCE: The home has a comprehensive Statement of Purpose and Service User Guide that is applicable to all the age groups of people who may wish to consider admission to the home. In addition, the home also publishes a Relatives and Residents Handbook which is given to all on admission to the home. All these documents are reviewed regularly. Each resident is provided with a written contract, which includes the statement of terms and conditions of their residence in the home. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 9 The Registered Manager assesses all new referrals to the home. A detailed assessment of each persons needs is completed and the outcome of this assessment, and how the home intends to meet the persons needs, is communicated in writing to the person who made the referral. Of the care plans reviewed such assessments were seen. It is the usual practice of the home for prospective residents to have a trial stay. This is followed by a review with all concerned parties. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) (OP) 7, 8, 9, and 10. (A18-65) 20. A Pharmacist Inspector completed an inspection of standard 9. The care plans for residents do reflect their current care needs. Consideration is given to all aspects of the persons needs. The majority of staff are courteous, polite and respectful. JUDGMENT OF PHARMACIST INSPECTOR The systems for the handling and administration of medicines are well organised. The home has policies and procedures in place to protect residents. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 11 EVIDENCE: The care plans of the most recently admitted residents had been based on the pre-admission assessment of the person. They clearly identified the health, personal and social care needs of the person. The care plans of more established residents detailed the same information and there was evidence that they were reviewed regularly and reflected changing needs. Some residents are subject to the provisions of Section 117 of the Mental Health Act 1983 and the Care Programme Approach; this is reflected in their care plans. Of the care plans seen it was evident that the residents health care needs are met. Records of visits by the GP and visit by the psychiatrist, employed by the home, were present. Risk assessments with regard to nutritional needs and pressure area care were in place and there was evidence that the optical and dental needs of residents are routinely reviewed. Of the residents spoken with all of them commented that the majority of staff they have contact with, are respectful, polite and courteous. They also confirmed that their privacy was respected. Several of the residents were very positive in their comments about staff such as, staff are very kind, carers cant do enough for me, they have time to talk to you; they cheer me up and make me laugh. However, some of the same residents identified two members of staff who they felt at times limited their choices and were not as polite and courteous as the other staff. This feedback was addressed to the Registered Manager who acknowledged that these issues had been brought to her attention in a recent residents meeting and she had taken action on the concerns. In the light of the findings of this inspection the Registered Manager intends to revisit the issues raised by the residents with the staff members concerned. EVIDENCE OF PHARMACIST INSPECTOR Medication records viewed were generally well filled in, showing that residents receive their medication as prescribed by their General Practitioner. Dose changes are clearly marked on the medication charts giving the authorising prescribers name - it is also recommended that these are dated, and signed by the prescriber if possible. Audit records are kept in the home showing medicines received into, and leaving, the home. Medication is stored safely and appropriately (including any controlled drugs and medicines requiring coldstorage). There are detailed policies and procedures in place and the home has regular advisory visits from their supplying pharmacist. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 12 ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) (OP) 12, 13 and 15. The home provides a full and varied activities schedule. It provides choices in the menus offered. EVIDENCE: The opportunities for leisure and social activities are varied and available each weekday. The home has an Activities Coordinator and five other Activities Assistants. Each of the units has its own assistants assigned to them and each Unit has a planned activity schedule. Activities were observed on both Units one and two and they were clearly enjoyed by the residents. In conversations with people they were very appreciative of the activities provided and said the staff were always open to suggestions and new ideas. The home also has its own transport, which several of the residents referred to, as they appreciate the opportunities for visits outside the home. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 14 Visitors are welcome to the home. There was evidence of written information being made available to them on notice boards and they had all been invited to a recent relatives and residents meeting. A relative reported her contentment with the care her husband received. She said the staff, were kind and always thinking about the care of the people in the home. She said that she had spoken to a number of other relatives and they all felt that when they said goodbye to their relative they felt, relaxed and happy knowing that they would be well cared for . The menu selections for the day were seen and they were noted to be offering choice and the meals were nutritious. The consensus of opinion of the residents spoken with was that the food was appetising. The refurbishment of the dining room in Unit one is almost complete and provides a bright and clean environment. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) (OP) 16 and 18. (A18-65) 22 and 23. The home has policies and procedures to ensure that residents are protected from abuse. The Registered Manager is knowledgeable about the protection of vulnerable adults. EVIDENCE: The complaints procedure in the home is well publicised. The homes complaints procedure is clearly detailed in all the published documents the home distributes to residents and their relatives. The home does keep a record of all complaints made and all investigations completed. One complaint has recently been received and has been addressed promptly by the Registered Manager. The home does have policies and procedures relating to the protection of residents from abuse. The Registered Manager is fully conversant with the local policy on the protection of vulnerable adults and the guidance on the Protection of Vulnerable Adults (POVA) register. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) (OP) 19 and 26. (A18-65) 24 and 30. The implementation of a refurbishment and decoration programme for the home has been a positive initiative. The Responsible Individuals commitment is crucial to its implementation. The evidence seen amply demonstrated this commitment. EVIDENCE: Following the pre-registration visit in September 2004 the home has devised a detailed programme of refurbishment and decoration for the next three years, which the Responsible Individual has given his commitment to. Areas of the home that, were detailed as priorities, have either been refurbished or are soon to be refurbished. There has been a significant improvement in the dining room of Unit one and, a corridor, womens bathroom and mens toilet in Wrens unit. In discussions with the Registered Manager and the housekeeper ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 17 the ongoing purchasing of equipment and furniture on a month-by-month basis is proving to be successful. This is a large home that does endure significant wearing tear. Some minor repairs were identified to the Registered Manager who gave her undertaking to address them promptly. It was necessary to issue an immediate requirement notice for the repair/refurbishment for the fixings of a magnetic catch on a fire door in Wrens unit. The Registered Manager gave her undertaking that this would be dealt with promptly. Confirmation has been received in writing, prior to the publication of the report, that the immediate requirement has been addressed. With the exception of the small lounge in Unit one the home is clean, pleasant and free from odour. It was identified that the carpet in the small lounge of Unit one needs replacement. The Responsible Individual gave his assurance that this would be replaced. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were reviewed on this inspection. EVIDENCE: These standards were not reviewed on this inspection. However, the manager was able to confirm that the home has a full staffing team. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) (OP) 33 (partial) and 38 (partial). (A18-65) 39 (partial) and 42 (partial). The home does see the value of checking the quality of care it provides, to ensure that the home is run in the best interests of the people who live there. EVIDENCE: In the past month the home has held a quality assurance meeting with the residents and their relatives. The outcomes of this meeting provided valuable information to the Registered Manager about the limiting of choices for some of ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 20 the residents on Unit two by a small minority of the staff. There was evidence to support the position that the manager had taken action on this however, as a result of comments received during the inspection she has given an undertaking to take further actions on the issues raised. The Training Manager was also spoken with regarding these issues (as she had been party to the meeting). She indicated that it was her intention to follow issues raised at the meeting during forthcoming training events. A sample of records, were checked to ensure the health, safety and welfare of service users and staff are promoted and protected in the home. They were all kept in accordance with the appropriate regulations and legislation. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 21 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 3 2 3 3 3 4 3 5 3 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 x x x x x x 2 Score Standard No 7 8 9 10 11 Score 3 3 3 2 x Standard No 27 28 29 30 x x x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 2 34 x 35 x 36 x 37 x 38 3 ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 22 N/A Are there any outstanding requirements from the last inspection? 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. 1. Standard 10 Regulation 12(4)(a) Requirement The Registered Manager ensures that all members of staff promote choice, privacy, dignity and respect towards the residents in the home. If deficits are found then appropriate action must be taken. To effect an immediate repair to a fire door hold/closure in wrens unit. To replace the carpet in the small lounge of Unit one. Timescale for action 31.5.05 2. 3. 19 26 23(4)(c) 16(2)(k) Immediate 30.6.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 19 9 Good Practice Recommendations To continue with the 3 year refurbishment plan as detailed following the pre-registration visit. That dose changes to medication administration record charts are dated, and also signed by the prescriber if possible. That the purchase of a digital maximum and minimum thermometer be considered for the medication refrigerator. ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 23 ASCOT NURSING HOME H52-H01-S62218-Ascot Nursing Home-V222276040505-Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 1015 Arlington Business Park Theale Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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