Inspection on 06/02/06 for Ash-Croft House Care Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ash-Croft House Care Home 12/06/08

Ash-Croft House Care Home 10/12/07

Ash-Croft House Care Home 09/05/06

Ash-Croft House Care Home 25/08/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ash-Croft House Care Home 10-12 Elson Road Formby Merseyside L37 2EG Lead Inspector Mrs Julie Garrity Unannounced Inspection 6th February 2006 10:50 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 Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ash-Croft House Care Home Address 10-12 Elson Road Formby Merseyside L37 2EG 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) 01704 874448 Cedars Care Group Limited Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the CSCI Date of last inspection Brief Description of the Service: Ashcroft House is a care home registered to provide nursing care for 31 older persons. The home is privately owned and the owner has other homes throughout the country. The care home is situated in the Formby area. The area around the Home is mainly residential and there are local areas of interest such as the squirrel park. There are shops directly opposite Ashcroft House and a main train and bus route within easy walking distance. Ashcroft House is converted from two previous houses. There are 2 main lounges, a quieter lounge and a lounge that is also used for dinning facilities next to the kitchen. There are 25 single rooms and 3 double rooms, 2 rooms have ensuite facilities. 5 of the bedrooms are situated up a small amount of stairs and do not have ramps or a stair lift to access them. Residents utilising this space must be either mobile enough to climb the stairs or do not wish to leave their rooms. Many of the residents have personalised their room space and have brought items of their own furniture, which assist in contributing to the homely appearance of Ashcroft House. There are 4 bathrooms and 3 shower rooms and sufficient WCs for service users usage. There are gardens to the front and the rear of the home that are well maintained and easily accessible by service users. A large car park area is located at the front of the building. Ashcroft House is a non-smoking building. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection undertaken by on inspector over a day. The total duration of the inspection was 5 hours. CSCI inspects “core” standards over 2 inspections. The core standards not covered in this report were covered in the previous report undertaken on 25/09/05. The inspector undertook this inspection by reviewing on-site records such as care plans, medications, daily records, staffing rotas, staff training and staff recruitment records. Other records reviewed were previous reports and CSCI records such as notifiable incidents and provider visit reports. Discussions were held with 8 residents, 2 relatives and 6 staff. The inspection was undertaken with the support of the acting manager and all areas were discussed with the acting manager as they occurred. Full feedback was given to the acting manager at the end of the inspection. All but two requirements from the previous report were addressed and one additional requirement was made in this report. None of the good practice recommendations had been utilised. What the service does well: What has improved since the last inspection? The new owner and acting manager have tried very hard to make sure that they have a well run, well managed home. The way that the home makes sure that staff are suitable has improved including training, supervision and checks before they are employed have all improved. The acting manager has also reviewed the documentation in the home including care plans to make sure that they do clearly detail the care needs of the residents. Although not put into place yet it is clear that the manager is aiming to improve the quality of the service provided. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 6 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. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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 Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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): 3 The home makes sure that it can meet the needs of potential residents before they move in. EVIDENCE: The acting manager makes sure that all new residents are assessed before they move in to Ashcroft House. Staff will visit residents before they move in and residents are invited to visit the home. At this time they and their families are given information about the home and the staff assess the needs of the residents. This information is later used to help the staff decide how to meet the resident’s needs. All the residents spoken with were complimentary about the care that they received one resident said, “I have such good friends here, the staff are great”. A relative spoken with explained her relative was “very well looked after, its great to go knowing she’s safe and good to come visit and be welcomed”. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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): 10 All residents are treated with respect and their dignity maintained. EVIDENCE: The staff team showed genuine kindness and respect for the residents privacy at all times. Discussions with staff detailed that they were aware of the how each individual resident preferred to be treated. One resident spoken with said, “staff are always very polite, they speak to me nicely and are very patient”. The acting manager has changed the medication arrangements and has noted that this has started to improve the way that medications are managed. A new recording system will be in place and this will help staff to manage medication administration better. A review of care plans has been undertaken. The acting manager has a simpler system to put into place. It is anticipated that this will help make care plans, clearer, more accessible by residents and staff and contain good clear instructions. At present the care plans do not detail the care needs of the residents. Two care plans viewed did not have a plan for needs that were identified in the resident’s assessments or where generally know by the staff. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 10 Wound records and the management of wounds have not improved and better monitoring of wounds remains outstanding from the previous report. It is anticipated by the manager that this too will be resolved with the new care plans. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 11 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): 15 The arrangements for meals in the home are in need of further development to make sure that all meals are balanced and cater for residents individual dietary needs. EVIDENCE: The majority of the residents spoken with enjoyed the food. Several stated it was “nice” and two said it was “tasty”. Two residents said that they thought “there isn’t a lot of choice” and that “it’s a bit boring”. The staff do ask residents what meals they would like to have and record this. However a number of residents do not recall what the choice was and there is no information available to the residents to remind them. The cook explained that company is investing in reviewing the current menus to include choices for special diets such as gluten free and diabetic. The present catering staff do not have any training in special diets and are keen to develop their skills further. The menus available have not been decided on with the residents, they were decided on by the previous owner and manager. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 12 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): 16 Potential complaints and concerns are managed well, residents and relatives have confidence that their concerns will be dealt with. EVIDENCE: The acting manager makes sure that any concerns are recorded, so that she can properly investigate them and address any concerns. One resident spoken with said that she’d had “a really minor issue, but the staff were great they really made sure that it was fixed”. A relative spoken with said, “whenever I’ve asked for something it’s been done”. A complaints procedure is available within the home and two residents spoken with were aware that it was available and how to access it. Training for staff with regards to raising concerns and the Protection of Vulnerable Adults has developed since the last inspection. A number of staff have undergone the training. Management and senior staff are more aware of their role. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 13 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): 26 The home is clean, pleasant and staff are aware of the ways to maintain good levels of hygiene. EVIDENCE: A review of the premises showed that the home has replaced a number of items of furniture and maintains the décor to a good level. Staff stated that there were always sufficient gloves and aprons available for them. Staff were also noted to use aprons at meal times in order to make sure that the food they were serving was not contaminated. Residents spoken with said that the home was “always clean, smelled lovely and pleasant”. A relative explained that “the staff are very thorough, they make sure that everywhere is tidy, smells lovely, this is not a home that ever smells”. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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 trained to do their jobs and make sure that residents are in safe hands at all times. EVIDENCE: The home has updated all the staffing records, which now reflect the checks that were done before the staff were employed. These included Protection of Vulnerable Adults checks, police checks and references. Staff training is being further developed and several of the staff have undergone training suitable to their job roles. A number of staff have a qualification specifically for staff in care and several other staff are waiting to start or complete the same course. One relative spoken with said “staff know what they are doing, the care that they give mum is absolutely excellent. Mum could not be better looked after”. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 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): 31, 33, 35 The manager is not registered with CSCI although an application has been submitted. The manager and the owner make sure that the home is run within the best interests of the residents. Resident’s interests and financial arrangements are safeguarded. EVIDENCE: The home has changed both the manager and the owner within the last 12 months. This change has been managed very well with residents, staff and relatives saying, “it’s much nicer”, “staff are still the same, the home is still good” and “the owner and manager are really great”. A quality assurance system that asks residents for their point of view is undertaken and the owner’s representative undertakes monthly unannounced visits and talks to the residents. The reports from these visits are not always received by CSCI. Residents spoken with said “my opinion matters” and “I feel I can say what I think and staff do something about it”. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 16 There are clear records kept for resident’s monies that are held by the home. Residents are made aware of what funds they have available and are supported to either take care of their funds themselves, relatives to mange funds or the home to assist. Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 17 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X 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 2 X 3 X 3 X X X Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1)(a) (b) Requirement Timescale for action 25/04/06 2. OP8 17(1) (a) 3 OP15 16 (2) (i) The manager must make sure that the residents written care plans and risk assessments detail how the residents needs in respect of health and welfare, are to be met. These must be regularly updated. (Outstanding from the previous report) 25/04/06 All pressure ulcers must have clear documentation detailing the actions that staff need to take in order to provide appropriate dressings. All wounds must have suitable tracking and descriptions of the nature of the wound such as photographs, wound mapping and/or clear description of size, location and grade if applicable. (This is an outstanding requirement from two previous reports) Menus must be developed that 25/05/06 reflect the dietary needs of the residents such as gluten free diets and diabetic diets. Menus must provided a varied, nutritional diet that is taken from the residents expressed, needs, DS0000064981.V282547.R01.S.doc Version 5.1 Ash-Croft House Care Home Page 19 likes and choices. 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 OP7 OP9 Good Practice Recommendations Advice and guidance as to the best methods to deal manage pressure ulcers should be sought. Points of advice would included, NICE, NMC and the PCT Medication arriving in the home should be clearly documented to include dose, drug, amount and who for. Staff should use medications only for the resident named on the label. All medications should detail the label directions. Two people should check all medications records in order to maintain accuracy. The practice of recording medications by box rather than over all amounts should be discontinued. The manager should consider either a menu-board that is regularly updated or published menus to make sure that residents are aware of the meals available. Consideration as to the residents who do not eat in the dinning room should also be made. Advice and guidance as to a nutritional diet should sought from a dietician. The good progress in medications, staff training and staff records should be further developed and continued. Consideration should be made to replacing the lino floors in three of the bedrooms. Staffing levels should be monitored in order to determine that the levels meet the dependency needs of the residents. The manager should monitor resident’s accidents in order to identify any residents who are at particular risk or events in the home that increase risk. 3. OP15 4. 5. 6. 7. *RCN OP19 OP27 OP38 Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. Extracts may not be used or reproduced without the express permission of CSCI Ash-Croft House Care Home DS0000064981.V282547.R01.S.doc Version 5.1 Page 21 - 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. 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