CARE HOMES FOR OLDER PEOPLE
Ashbourne Court Residential Care Home Ashbourne Court Ashbourne Close Ash Hampshire GU12 6AG Lead Inspector
Peter Benthom Announced Inspection 17th October 2005 10:00 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 Court Residential Care Home DS0000061309.V252184.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. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ashbourne Court Residential Care Home Address Ashbourne Court Ashbourne Close Ash Hampshire GU12 6AG 01252 326769 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) Ashbourne Court Residential Care Home Ltd Mrs Anusha Doorga Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The age/ age range of service users to be accommodates will be: OVER 65 YEARS 21st April 2005 Date of last inspection Brief Description of the Service: Ashbourne Court is a privately owned care home. Personal care and accommodation is offered for up to 10 older people in the category of old age only. Located in a quiet residential area of Ash, the home is in close proximity to shops and all other community amenities. Ashbourne Court is a large detached property with parking facilities to the front and an attractive enclosed garden and furnished terrace to the side. Accommodation is arranged over two floors with all communal facilities located on the ground floor. Service users have their own single rooms with en-suite facilities. The home benefits from a stable suitably qualified and experienced staff team and is managed by the owner. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. The care plans in place were comprehensive and are reviewed on a regular basis to ensure that they accurately depict service users’ needs. The home provided a high level of individualised support to service users. This unannounced inspection took place over 2 hours. A tour of the premises took place. Four Service Users were spoken with and staff on duty were spoken with and observed in carrying out their duties What the service does well: What has improved since the last inspection?
The proprietor and staff team have a thorough awareness of the needs of the Service Users in this home. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 6 Service users are admitted only following a full assessment undertaken by the manager and the proprietor who are able to demonstrate the homes capacity to meet the assessed needs. Each service user has a clearly set out care plan and all the service users are registered with a GP. There were satisfactory facilities and procedures available for the safe reception, storage, disposal, administration and recording of medication. Arrangements are in place to meet service users care needs in a respectful way that affords both privacy and dignity. Staff are committed to encouraging service users to take part in the daily activities that are offered in the home. Full support is provided to enable individual choice in daily living activities. There is a commitment from the proprietors to offer as much opportunity as possible to staff to undertake appropriate training. As a consequence 50 of care staff have achieved NVQ Level 2 or 3 in care. 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. Ashbourne Court Residential Care Home DS0000061309.V252184.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 Ashbourne Court Residential Care Home DS0000061309.V252184.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): 1,2, 3, 4, 5 and 6 Service users are admitted only following a full assessment undertaken by the manager and proprietor who is able to demonstrate the homes capacity to meet the assessed needs. EVIDENCE: The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. This is in the process of being revised as the home is looking to provide specialist care for older people with dementia in the future. All potential service users are assessed prior to admission. It was reported that the service only admits new service users based on an assessment of needs, and appropriateness of placement The initial assessment was used to form the basis of the care plan and the support plan, which identified the actions that carers should follow to assist an individual living at the home. Ashbourne Court Residential Care Home DS0000061309.V252184.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): 7, 8, 9, and 10 Health, personal and social care needs are effectively met in this home. Service users’ health needs were well met and medication administration was accomplished satisfactorily. EVIDENCE: Care plans sampled were comprehensive and up to date; there was evidence that regular reviews took place. Encouragement and support was given to service users to promote independence within the limitation of each individual’s capabilities Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 10 The care plan is preceded by the full assessment of health and personal care needs, which is undertaken by the manager /proprietor. The assessment is carried out in full co-operation with the care manager and/or the referring agency. If the service user is privately funded, a full assessment also takes place. The assessment is ongoing when the Service User is admitted to the home. Medication is stored in a locked metal trolley and all senior staff are trained in the administration of medication. During the inspection the staff cared for Service Users in a respectful manner. Those Service Users requiring any assistance were helped sensitively. All Service Users have their own bedroom, thus providing the opportunity for privacy when visitors arrive, whether family or professionals. The Homes’ policies and procedures placed particular emphasis on the core values of caring, such as independence, privacy and dignity. Care plans sampled were comprehensive and up to date; there was evidence that regular reviews took place. A policy and procedure for the administration of medication was sampled as part of the inspection process. Evidence that Service Users’ optical, dental and chiropody needs are met and confirmed in the diary and other records. Where appropriate, occupational therapists, dieticians and speech therapists would be involved in Service Users’ care. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 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): 12, 13, 14 and 15 The systems in place for full Service User participation indicated that Service Users views are both sought and acted upon. EVIDENCE: Service Users spoken with expressed a positive view of day-to-day life in the home and staff interaction with Service users was respectful yet informal; and all staff interviewed had a thorough knowledge of Service Users and their needs. Organised activities take place on a daily basis and take place in the lounge or dining room and Service Users choose to participate if they wish. Service Users do not handle their own financial affairs. If they are unable to manage their finances, relatives or advocates act on their behalf. The menu on the day of inspection was found to be wholesome, nutritious and very well presented. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 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, 17 and 18 The home has a satisfactory complaints system that is made available to all Service Users and their relatives and staff of the home. EVIDENCE: The home has developed its complaints procedure to incorporate details of the Commission for Social Care Inspection. The main complaints procedure makes reference to the details of how to contact the Commission. The majority of senior staff have had recent protection of vulnerable adult training updates as an integral part of their ongoing training. Training records and displayed certificates sampled, evidenced that staff had received training for the Protection of Vulnerable Adults. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 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): 19, 20, 21, 22, 23, 24, 25 and 26 The standard of décor and equipment in this home is of a very high standard with evidence of improvement through maintenance and refurbishment when necessary. EVIDENCE: The Home is situated in a large and well-maintained garden and is close to Ash village centre. The Home has been tastefully designed to meet the needs of older people. Ashbourne Court is accessible and well maintained. There are ample dining and lounge areas. This Home’s facilities for washing and toileting meets the minimum standards expected. All rooms were accessible to Service Users. The home has grab rails and adaptations in place to support Service Users to maintain their independence. Ashbourne Court Residential Care Home DS0000061309.V252184.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): 27, 28, 29 and 30 Service Users are supported by competent and trained staff who have a good awareness of their needs. EVIDENCE: The Home has a policy whereby all gaps in the staff rota are met by using existing staff. This helps to promote consistency in care for Service Users. The Home has a continual programme of NVQ training for all staff and is committed to staff training. All staff have completed induction and foundation training and there is a good training package for all staff. The Home is working towards meeting this standard. Staffing levels comply with National Minimum Standards. There was evidence that the recruitment process had been followed and met the standards for protection of Service Users. There are arrangements to carry out CRB checks and two written references were in place for all staff. Ashbourne Court Residential Care Home DS0000061309.V252184.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): 31, 32, 33, 34, 35, 36, 37 and 38 The manager is supported by staff in providing clear and consistent leadership in the home with all staff illustrating an awareness of their roles and responsibilities. All service users and staff are protected by the home’s record keeping and health and safety policies. EVIDENCE: The manager has completed NVQ Level 4 training and the Registered Managers Award. Information from service users and staff confirmed that the management style in the home was open and that the registered proprietor/manager is approachable at all times. The staff-training programme includes training in first aid, manual handling, infection control, fire safety, health and safety and basic food hygiene. Five members of staff will be embarking upon a distance-learning module to increase their knowledge of dementia.
Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 16 Systems were in place to safeguard the health and safety and welfare of the service users. Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 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 3 3 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 3 3 3 3 3 3 Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 18 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. 1 Standard OP3 Regulation 14 (1)(a)(b)( c) 14 (2)(a)(b) Requirement It is required that all information on all prospective service users is received prior to admission as part of the assessment It is required that a full assessment is completed on LH prior to his potential readmission to the home Timescale for action 31/10/05 2 OP3 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashbourne Court Residential Care Home DS0000061309.V252184.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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