Inspection on 18/10/06 for Ashbourne

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ashbourne 16/01/09

Ashbourne 06/10/05

Ashbourne 10/06/05

Ashbourne 23/11/04

Ashbourne 23/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ashbourne Byways Selsey West Sussex PO20 0HY Lead Inspector Mrs H Church Key Unannounced Inspection 18th October 2006 09:15 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 Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 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. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbourne Address Byways Selsey West Sussex PO20 0HY 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) 01243 604612 Mr John Viret Wilford Mrs Susan Mary Wilford Mrs Natasha Honywood Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 Brief Description of the Service: Ashbourne is a private care establishment registered to accommodate eighteen service users in the category of Older People. The property is detached and in a quiet area of Selsey. The house is a few yards from the sea front and ½ mile from the town centre. The accommodation is mostly arranged on the ground floor with the first floor accessed by stairs or a vertical lift. All rooms have ensuite facilities and following extensive alterations and new extensions, all are single rooms. The first floor has an assisted bath and the ground floor has both a disabled and an independent shower room. A new conservatory and extended dining room increases the communal space. Mr and Mrs Wilford privately own the establishment and Mr Wilford is the Responsible Individual. Mrs Natasha Honywood is the registered manager and responsible for the dayto-day management of the establishment. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Ashbourne have improved their records, implementing a new system and this is a great improvement on the previous system. However, some of the care plans gave conflicting information and some information was absent. The recruitment procedures were in place but some information has been accepted without confirmation. The induction and foundation workbooks did not contain Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 6 sufficient information about care practices or allow the students to be reflective in their consideration of care practices and include written responses. The manager agreed to contact a training company for some advice. 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. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 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 Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 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): 1,2,3,4,5. All new residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four residents, one new and three existing residents were case-tracked. The manager was present throughout the inspection. The inspector examined the Pre-Assessment records and noted that where residents are self-funded, these were present and for those residents funded by the Local Authority, the social worker had provided a care assessment. All residents had been assessed prior to their admission to the home to ensure the home could meet the needs of all prospective residents. The pre-admission assessment used is comprehensive Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 9 and includes all the areas required for making a decision. The Statement of Purpose and Service Users Guide are regularly updated and the Commission for Social Care Inspection and residents all receive the updated copies. Two visitor and the new residents confirmed they had received the Statement of Purpose and Service Users Guide when enquiring about the care provided. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10. All residents had an individual care plan set out for staff to follow. The home operates a policy where all medication is managed by care staff. Care staff are meeting the health care needs of the residents in a respectful manner. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four care plans and assessments were examined and were seen to include some aspects of the health, care and social needs of the resident. Risk assessments and nutritional assessments formed part of the care plans. The inspector did observe that the risk assessments gave staff better information than observed at the previous site visit but noted that care plans would have benefited from more information and that the overview sheet detailing the current care needs, required updating from recent information. However, the Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 11 inspector did note that care plans reflected the needs of residents and the risks to their health, safety and welfare, including falls and pressure areas. Staff were well informed of the current situation and care plans were up to date and reviewed regularly. The inspector noted that new residents are being involved in the care plans and that the new resident and her relatives were aware of this process. The personal items brought in by the resident had been recorded and agreed by the relatives. The home’s medication procedures ensure safe practice with the handling, administration, storage and disposal of medicines. Staff have been assessed as competent to undertake the medication procedure and closely monitor any resident who wishes to manage their own medication to ensure the agreement to manage and store this safely is maintained. MAR charts were accurate with no gaps noted in recording of administration of medicines. Links are made between residents needs and determine the care provided. Where district nurses are providing a service, the information was current and relevant to the care being provided. The inspector discussed this aspect of care with a district nurse visiting at the time of the inspection and excellent feedback was received regarding referring residents appropriately and following instructions to a high standard. Where specialist equipment had been identified, this had been provided. The inspector observed that where one resident required a hospital bed, this had been obtained. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 12 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): 12,13,1,4,15. Activities are suitable for current residents, visiting is positively encouraged and residents are served meals that are nutritious and appetising. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There are seventeen residents living in the home at present and care staffing hours are good, giving care staff opportunity to spend individual time with the residents. According to five visitors, they are always made welcome and are welcomed at any time. The visitor’s book confirmed this. A programme of activities was observed and residents confirmed this was provided. Currently, activities are based on resident’s wishes and abilities with any new activities being provided from residents’ requests. Activities range from individual to group activities and range from music and movement sessions to quizzes and games led by a professional organisation. A recent trip Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 13 was provided for a cream tea to a local garden centre. Recently residents had completed a questionnaire and activities formed part of this. Generally, most residents were happy with current arrangements. The dining area looked very inviting and was arranged to encourage residents to sit at tables laid for up to four persons but also to communicate with other residents. The resident’s comments included praise for the home cooked food and found it fulfilling with good choices. The inspectors spoke with the manager and the cook and it could be seen that dishes were prepared according needs and wishes of the residents. The inspector observed the high quality of the home-made meal, all prepared from fresh ingredients. The menus are changed regularly according to feedback. Where residents prefer an alternative, this is provided and the inspector noted two alternatives provided on the day of the inspection. Where residents need special diets, these are provided. It was clear that meals are a high focus for all residents. The kitchen was fitted with spacious and well-organised work surfaces with well-maintained equipment giving staff the means of providing a good choice of meals in a hygienic and specialist area. Where residents are unwell or prefer to eat in their rooms, individual trays are laid with napkins, drinks condiments and a good range of cutlery. Staff assistance was provided in one case where the resident was unable to manage without help. Dietary needs are recorded in the individual care plans and these are taken into consideration when planning meals. Weight charts were absent on most records where staff believed there to be no problems. However, the manager agreed to reinstate these on all residents to ensure all aspects of health care and meal planning are linked. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 14 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): 16,17,18. Residents are confident that complaints are taken seriously and acted upon appropriately. Staff have had in-house training in adult protection procedures so are equipped to protect residents from abuse. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The complaints procedure was displayed in the hallway with the Visitor’s Book and included in the Statement of Purpose and Service Users Guide. The complaints log was examined but there had been no complaints recorded. Four residents told the inspector that they had no hesitation in speaking to the staff or manager if there was anything they felt unhappy about. The staff confirmed that in-house training for Adult Protection Training had been given but as this was some time ago, it was agreed that a course is identified to update practice. The West Sussex Multi Agency Guideline was present in the office and made available to staff at all times. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 15 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): 19-26 inclusive. The indoor and outdoor areas used by residents are clean, safe and homely with good access to all parts. Resident’s rooms are suitable and homely. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector toured the building and examined specialist equipment to ensure residents are safe and enjoy surroundings. The indoor communal areas, garden and individual room areas are safe and well arranged to maximise independence without compromising a sense of freedom. The inspector examined the risk assessments for the building and found it to be appropriate. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 16 Throughout the tour the home presented as clean, pleasant and hygienic, equipment was being maintained and the redecoration, refurbishment programme continues. All residents have lockable rooms with some having lockable furniture in their rooms. All of the radiators are guarded and thermostatic valves are in place to restrict water temperatures to safe levels and protect residents from burns and scalds. As residents leave rooms, these are well decorated according to the residents wishes, furnished and arranged to the needs of residents. One resident was very complimentary about the care taken to ensure her room was decorated and furnished with her furniture. She said it made her feel very much at home very quickly when she first came in to Ashbourne. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30. The duty rota indicated that sufficient staff with a suitable mix of skills and experience are on duty over the 24 hours period to ensure needs can be met. Recruitment processes were in place to ensure residents are protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector observed that the staffing rota, examined in conjunction with care plans, showed that the staffing levels do ensure residents needs can be met at all times. The inspector observed that staff spent quality time with residents in the communal areas as well as ensuring residents who chose to remain in their rooms were given staff time as they needed or wished. During the fieldwork, the inspector spoke to residents about the time spent with staff and all of the comments were good. Residents also felt their privacy and dignity is maintained and four residents commented that “staff were kind and thoughtful”. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 18 The homes use of agency staff is minimal as staffing absences are generally covered by existing staff but if needed, the prospective manager has authorised access to monies for this at all times. The inspector observed that domestic and catering roles are staffed separately with staff having clearly defined roles for these. The inspector examined recruitment procedures to ensure that the home continues to meet this standard. Two staff records were examined in conjunction with their training records and noted that the recruitment process generally was good although some information was obtained and recorded without confirmation. All staff, whether care or ancillary, complete the induction and foundation training course work, although the inspector observed that the student was not able to record any reflective responses to care practices and that these in themselves were not sufficient. The balance of practical work in conjunction with attitude and approach required more consideration. The manager agreed to look into obtaining more appropriate induction and foundation training and mandatory training work packs. The inspector noted that all staff have received mandatory training at appropriate intervals with some additional periphery courses on the care needs of this group of residents. National Vocational Qualifications at levels 2 and 3 are provided although the home have not yet obtained the National Minimum Standard of 50 of care staff with National Vocational Qualifications. Records showed and staff on duty confirmed that they had only been employed following a Criminal Records Bureau clearance. The staff on duty confirmed that training has been provided and that all staff have received some training applicable to their roles and level of expertise. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36,38. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager and the staff work exceptionally well together in providing a care home where outcomes for residents are extremely good. The supervision procedure was examined and although some gaps were noted, generally this is provided at the required intervals with training needs are identified from this procedure. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 20 A Quality Assurance System has been completed and includes all aspects of care as per the views of the residents. The inspector examined the format of these and noted that residents are encouraged to suggest improvements to all aspects of their lives at Ashbourne but very few additions were suggested. However, the inspector recommended that the results be analysed for residents to see that their views have been noted. The manager holds ad hoc meetings with residents according to the comments made. The inspector observed the informal and on-going system of seeking views from residents and visitors at every opportunity during the site visit. Residents are encouraged to manage their own finances or if this is not viable and a representative of the resident take on the responsibilities for this. However, in two cases, the manager has agreed to take on this role in keeping monies on their behalf. The inspector examined both records and found them to be accurate. The inspector noted that the documents used to record accidents meet the Data Protection Act although outcomes are not recorded where information could be analysed easily. The manager agreed to include outcomes on the reverse side of the Accident Record. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Good moving and handling practise was observed that minimises risks to residents’ health safety and welfare. Policies and procedures were in place and had been updated recently. The inspector concluded that the health care needs of all of the residents were being safely met. Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 22 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. 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 Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Ashbourne DS0000014368.V314257.R01.S.doc Version 5.2 Page 24 - 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!