Inspection on 12/07/05 for Ashbourne House

This inspection was carried out on 12th July 2005.

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 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 House 09/05/07

Ashbourne House 06/12/05

Ashbourne House 07/02/05

Ashbourne House 08/09/04

Ashbourne House 24/02/04

Ashbourne House 17/06/02

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

CARE HOMES FOR OLDER PEOPLE Ashbourne House 147/149 Gatley Road Gatley Stockport SK8 4PD Lead Inspector Kath Oldham Announced 12 July 2005 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. 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 House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashbourne House Address 147/149 Gatley Road, Gatley, Stockport SK8 4PD 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) 0161 491 1201 Casequest Limited Martin Sorell Care Home 23 Category(ies) of OP - Old Age (23) registration, with number of places Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2005 Brief Description of the Service: Ashbourne House is a 23-bedded care home for older people, situated close to Gatley village. Public transport and the motorway network are within easy reach of the home. The accommodation within the home consists of 19 single and two shared bedrooms. There are four domestic size lounges and a large dining room. There are televisions in three of the lounges. The fourth lounge acts as a quiet reading/visiting room. There is a loop system available for service users who are hearing impaired. The dining room overlooks a well-established, enclosed garden where seats/ chairs are available for service users and their visitors. The home also provides a small, purpose-built, domestic size, kitchen in addition to the central kitchen used to cook meals for the service users. The small kitchen is available for service users and their visitors to make hot drinks. There is a multi-purpose function room for hairdressing, chiropody and other consultations. The hairdresser visits the home on a weekly basis. Within the same room there is a public telephone available to service users. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place in July 2005. The inspector spent time in conversation with service users and staff in addition to speaking to the owner and manager. Observations of staff practice and routines were undertaken, as was the examination of a sample of documents and files, which need to be maintained in line with regulation. A tour of the premises was also undertaken. Comment cards were sent to GP’s, relatives and service users; their comments are included in the report. All developments required as a result of the last inspection had been completed. What the service does well: Staff felt they provide an excellent level of care and support to service users through hard work and regularly updating their training. Staff said they felt that any service user would let them know if they were unhappy with any aspect of care and support provided by the home. Staff said they work hard and enjoy the work they are employed to do. Service users said there was always a happy atmosphere at the home and nothing is too much trouble for the staff. Training is provided to staff and updates are scheduled on the yearly planner, which ensures training doesn’t get forgotten. Over 50 of staff have obtained NVQ level 2. Two staff have undertaken NVQ level 3 and two have already completed this. The manager and a member of the senior team have obtained their accreditation to be NVQ assessors so this means that they are able to guide their staff through the NVQ process. The manager continues the development of the home by keeping in touch with changes in care practices and routines. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 and 5 Service users are provided with information to enable them to make a decision as to whether the home can meet their needs. EVIDENCE: Service users said they looked around the home prior to making a decision whether to stay at the home. A number said they had a trial stay for six weeks after which their decision was made. Contracts were observed on service users’ files examined. The detail needs to be amended to ensure all the facts are available. Information was received by service users or their relatives about the service and facilities available at Ashbourne House. A copy of the service user guide was available in the service users’ files examined. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 9 An assessment is undertaken by the manager before the service user visits the home to ensure the home has the skills and ability to meet their needs; this usually takes place in the service user’s own home or in hospital, whichever is appropriate. The assessment looks at service user’s needs and abilities and also looks at the current service user group to see if they will be suited to the home and its surroundings. Staff said service users usually come for the day and have meals and spend time with other service users as part of their information gathering about the home. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Systems are in place to ensure, as far as possible, service users maintain good health, however care plans need further improvement to reflect this. EVIDENCE: Relatives and visitors said the home had instigated investigations into their cared for relative’s health care needs and had been thorough in ensuring health consultations and investigations take place. One service user said she forgets things and does not always know the time of day, but she knows she has nothing to worry about as the staff will look after her and make sure she is well. Visiting professionals said the home works with them in promoting service users’ healthcare needs. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 11 Service users said that, in the main, they had kept the same doctor, who knew them well, when they moved into the home. A number of service users have moved to Ashbourne from out of the area and their doctors have not been able to continue with their healthcare because of geographical boundaries. Service users said the manager had arranged for another doctor to visit them who they are now registered with. Service users’ weights are recorded to ensure they are not losing weight. One service user said that some of the service users are weighed more regularly and this was due to the home needing to keep an extra check on them. A service user was aware of what medication she was prescribed and said she received it as directed by her doctor. The service user said “the doctor is called when you feel unwell”. The service user also said they attended the chiropodist and optician as they need to. Examination of the medication records identified that service users were given the medication as prescribed. Staff who have received medication training and are deemed competent by the manager administer medication to service users. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Service users have a flexible lifestyle in the home and maintain contact with their families and friends. EVIDENCE: One service user said they go out each day to the shops or for a walk and is supported by staff to do this. One service user helps to lay the tables, another gives out refreshments. One service user said they do what they want, get up and go to bed when they are ready and see whom they want and go out if they feel like it. Relatives said there were no restrictions on visiting and they visit when it suits them and their cared for service user and spend time in the lounge or in the service user’s bedroom. Service users were seen reading newspapers and “keeping up with what was happening in the world”. A couple of service users were seen to do crosswords. One service user said she did puzzles and crosswords in her room and “didn’t know what she would do without them”. Another service user said they had made some good friends at the home and was comfortable. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 13 A relative said they currently spend a lot of time at the home as their cared for service user was unwell. They said they were made to feel welcome and were offered refreshments whilst at the home. Service users were aware of what meals were being served and made some choices on the meals they eat. Service users said there was a choice at each meal and “if you didn’t fancy that, the chef would make you something else”. Service users said that the menus are changed periodically and the manager or chef runs by ideas and suggestions with them for different meals. Service users said the meals were good and there was always plenty to eat with additional helpings. The checks in relation to food and freezer temperatures by the cooking staff, which must be in place in line with Food Hygiene Regulations, were undertaken and recorded. The meals at the inspection were attractively presented and time was taken by staff in supporting and encouraging some service users to eat their meal. One service user said they felt happy with their life and did what they wanted to do. Service users met up at certain times of the day to sit and chat and discuss current events. Service users commented that the garden was always nice and were seen sitting out. Garden seating was positioned so that service users could sit in the sunshine or shaded areas. One service user who has an interest in gardening pottered in the gardens tending the plants. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 A thorough complaints procedure known to service users was in place. Systems and routines are in place to protect and safeguard service users from abuse. EVIDENCE: Service users said if they had problems they would speak to the manager or the owner who calls in the home regularly. A complaints procedure is in place and describes the steps that will be undertaken to investigate any complaints or comments. Staff said they had every confidence that service users and their relatives would approach any member of the staff team with any comments or complaints. Staff have, in the past, attended training on what constitutes abuse and are scheduled to attend further abuse training later in the year, arranged by the local authority. The training will ensure they are able to recognise potential abuse. Staff appeared to have a clear understanding that any form of abuse would not be tolerated and they have a whistle blowing procedure which they would follow. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 23, 24, 25 and 26 Ashbourne House is a safe and well maintained home. EVIDENCE: Examination of the records identified safety checks undertaken to the equipment in the home. Regular service contracts were in place, in addition to the maintenance man coming to the home to do routine jobs. The home was clean and tidy. Domestic routines keep the environment clean, with adequate numbers of staff to keep the home odour free. Service users have access to the four lounges and communal dining room, which leads to the well-kept mature rear garden. Service users were seen using the garden to sit out and relax. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 16 There are four toilets on the ground floor which service users use during the day. A consultancy room is available which service users said was used for private consultations, hair appointments and the pay phone is in this room. Service users reported that they are supported in their independence and the staff team respects their privacy. Service users’ bedrooms had everything in them to make them feel comfortable and at home in their surroundings. A number of service users have brought into the home small items of furniture, ornaments and pictures to make the room their own. The bedrooms were clean and some had supplementary heating, which could be used by service users in colder weather. One service user said when the heating is not on at the home or you want the bedroom to be warmer, you are able to switch on the wall heating. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 There was an appropriate number of staff who were trained and competent to meet the assessed needs of service users. The procedures for the recruitment of staff were robust and thorough. EVIDENCE: Service users said staff were “kind and considerate” and “would do anything for you”. Service users said they felt safe at the home Many of the staff have received NVQ training and are able to use their skills to provide the right level of care to service users. Service users said “you only have to ask and staff will provide for you”. Examination of a sample of staff files confirmed that staff recruitment was thorough and robust, including receipt of references, employment history and CRB disclosures. Staff have received updates to their moving and handling training to make sure the techniques used are safe and are in line with health and safety guidelines. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 18 A training programme is in place for the year and includes some updates to past training and some first time training in dementia care and health and safety. Staff said they feel that they provide a good quality of care to service users. The cook has attended food hygiene training and is hoping to undertake the advanced food hygiene training to further her knowledge, which ensures that the correct standards are in place when preparing meals for service users. One cook has attended, by invitation, the Gordon Ramsey master class where tips and advice were given which assist in the development of the food served to service users. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 & 38 The management of the home are approachable and focus on meeting the needs of service users. EVIDENCE: The manager has been in post for a number of years and is well respected by both service users and staff. Staff ask for guidance and assistance from the manager to assist in their own development. Service users were complimentary about the manager’s skills, willingness to help and his management of the home. The manager has NVQ level 4 qualification and keeps up to date with techniques and development of care through the attendance to additional training and through research. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 20 A quality audit questionnaire has been issued to service users. The results of this have been analysed and action taken to address any areas of development. The manager reported that suitable accounting and financial procedures were in place in connection with the business of running a home. Staff meetings are arranged. Staff reported that this provides them with an opportunity to comment on the running of the home and to further develop standards. Formal service user meetings are not arranged. Service users commented on feeling as if their views and opinions were taken into account and commented on seeing the manager and discussing topics as they are identified. Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 3 Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 22 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 OP7 Regulation 15 Requirement The registered person must further develop the care plan to include all areas of the assessment and the standards. Timescale for action 01/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP2 Good Practice Recommendations The registered person should amend the residents contract to include their right to complain directly to the CSCI and delete the reference to the local authority and the ombudsman and the number of times CSCI inspects. The registered person should record the content of discussions and meetings with service users. 2. OP33 Ashbourne House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL6 0QD 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 House F54-F04 s8537 Ashbourne House v233215 120705 Stage 4.doc Version 1.30 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!