Inspection on 16/11/07 for Ashbourne House

This inspection was carried out on 16th November 2007.

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 26/04/07

Ashbourne House 11/07/06

Ashbourne House 20/12/05

Ashbourne House 26/04/05

Ashbourne House 07/12/04

Ashbourne House 08/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Ashbourne House Ashbourne House 213 St Marychurch Road Torquay Devon TQ1 3JT Lead Inspector James Rose Unannounced Inspection 09:00 16 November 2007 th 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 House DS0000018319.V351166.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 House DS0000018319.V351166.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbourne House Address Ashbourne House 213 St Marychurch Road Torquay Devon TQ1 3JT 01803 327041 01803 310587 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) Mr Robert Gisburn Williamson Mrs Diana Dolorse Enilde Williamson Mrs Sandra Brown Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (28) Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can admit one Service User, who is within category, but under 65 years of age. 26th April 2007 Date of last inspection Brief Description of the Service: Ashbourne House is a large detached property in a level residential area close to St Marychurch precinct, which has shops and other facilities. The home can accommodate up to twenty-eight people (some in shared rooms) from the age of 65. They may be physically and/or mentally frail, but the home does not cater for people in advanced stages of dementia or those exhibiting extreme behavioural problems. The double bedrooms are normally occupied singly. There are extensive communal areas on the ground floor, including a large lounge, dining room, quiet visiting room and an activities area. There are stairlifts on the main staircase to the first and second floors. However there are several bedrooms, which can only be reached via a few steps, and so are suitable only for residents able to walk up/down some steps. One of the bathrooms (first floor) is fitted with a bath hoist. There is an attractive level garden, a courtyard and a small car parking area. A minibus is available to residents for outings. The owners also manage a day centre (separately staffed) adjoining the home, where more able residents of the home may be able to join in activities. The weekly costs of care at Ashbourne House are currently: lowest £320.00 and highest £440.00. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was undertaken over 7 hours in November 2007. A complete tour of the home was undertaken and samples of care records were examined. Four residents were asked for their views, in private, of the service provided and two visitors were also consulted. Evidence was also gathered from questionnaires that were returned to the Commission and healthcare professionals were asked for their views of the service. The way care was delivered was observed and two carers were consulted individually. The inspection was undertaken with the assistance of the proprietors and the registered manager. What the service does well: What has improved since the last inspection? At the time of the last inspection two requirements were raised concerning residents care plans, one called for all a persons social needs to be included and the other concerned risk assessments. The home has undertaken this work and satisfied both requirements. One other requirement was made which called for the registered manager to ensure that carers adhered to the correct procedure for the administration of medication in the home. All the systems were examined at this inspection and were found to be up to date and complete. This will ensure that residents are appropriately protected. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 6 A sustained investment has been made by the proprietors to improve the building, the outstanding electrical work has been completed and replacement double glazed windows have been fitted. In addition the hot water outlets have had thermostats fitted, which will ensure residents are safe. The proprietors have also purchased some new equipment for the home’s laundry; and they have replaced the minibus. 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. The summary of this inspection report can be made available in other formats on request. Ashbourne House DS0000018319.V351166.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 House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. The home undertakes detailed assessments with prospective residents prior to them being offered a service which ensures they can meet all the person’s needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of four assessments were examined at this inspection, they were all comprehensive and needs were covered in the areas of health, personal and social. Assessments were undertaken prior to the home offering a service to ensure all needs could be met. Social needs were discussed with the registered manager who has agreed to provide greater detail to enable a more client centred approach to be taken in their care plan. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 9 For residents who are admitted to the home on an emergency basis and no opportunity has been available for an assessment to be completed this process is given priority to inform the care planning. Four residents were consulted on the day of the inspection and they all stated that all their needs were met by the service given by the home. One resident said, “This couldn’t be better for me here” and another remarked “I’ve been in other homes this is better”. Standard 6 refers to a service not provided at Ashbourne House. Ashbourne House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Detailed and comprehensive care plans were available for each resident. Health needs were fully met and residents who wish can self medicate. The administration of medications is appropriate and ensures residents are safe. Residents are treated with respect and their privacy is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Samples of the care plans were examined and a detailed comprehensive plan was available for each person receiving a service in the home. Needs were recorded in the areas of health, personal and social. Detailed risk assessments were also available. Some development has been undertaken by the home of the social needs since the last inspection and this work was discussed in detail. It has been agreed that some further development will be carried out which will enable the home to undertake a more client centred approach to the service provided. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 11 Health needs of residents were well covered and all the healthcare professionals contacted as part of the inspection process confirmed that they had no concerns about the service provided at the home. Residents also confirmed that they were able to see their doctor when they needed to. Residents that wish are able to self medicate subject to a risk assessment process to ensure they have the capacity and are safe. The recordings of the administration of medications in the home were examined and found to be complete and up to date. Medication was checked and booked in when received. An issue record was maintained and unused medication was returned to the pharmacist after being recorded appropriately. Secure storage was in place and appropriate procedures were used for medication subject to the controlled processes, this will ensure that residents are safe. All the residents consulted advised that they were always treated with respect and that care was taken to ensure their privacy was maintained. One resident said, “The staff are very good, you know, they will always help, nothing is too much trouble” and another remarked “No problems here, the carers treat me well”. Ashbourne House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. A good activities programme is in place and the home is moving to a more client centred approach for residents. Time, care and support is given to residents to assist them to make their own decisions. A wholesome balanced diet is provided at the home and meals are served in a dedicated dining room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an activities programme in place for residents that is much enjoyed. Currently this is of a general nature and is not yet generated from a client centred approach, however the home is developing this approach and this process will be complete in the near future. All the residents that were consulted during the inspection advised that they felt they had sufficient activities available and advised that they enjoyed the programme. Two visiting relatives were consulted as part of the inspection process and they stated that they felt the service at the home was “very good” and suited their mother very well. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 13 The home has a clear visiting policy and procedure that is unrestricted; visits can be made at anytime. Residents are taken out by their relatives and some are able to access the community facilities on their own; residents can come and go as they please. Time and care is taken by the home to assist residents to make their own decisions this was confirmed in conversations with residents and from observations made during the inspection. One resident said, “I make my own choices and they wait for my answer”. Residents’ preferences are recorded in their care plan. Some residents were consulted individually and some were seen in small groups, they all advised that they like the meals served at the home and said they always had choice about what they wanted to eat. A wholesome balanced menu was followed by the home with changes discussed with the residents before being implemented. A good quality meal was provided on the day of the inspection that residents said they really enjoyed when asked. The meals in the home are usually taken in the dedicated dining room where they are served at small tables sitting up to four people. Ashbourne House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents were confident that if they raised an issue with the home it would be taken seriously and resolved for them without delay. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents consulted during the inspection process advised they were aware of the complaints process in the home and stated that if they had a matter they wished to raise they would bring it up with the management of the home who they felt would resolve the matter quickly for them to their satisfaction. No complaints were made during the inspection. The home has available an adult protection procedure that is based on the legislation and provides clear direction for staff. Two carers were interviewed as part of the inspection process and both had received training in the procedure and were able to demonstrate their competence. Ashbourne House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This home provides an environment for the residents that is comfortable and safe, some areas will improved once the already planned redecoration has taken place. The building is clean throughout with good standards of hygiene in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken at the time of the inspection and all rooms were seen. Since the last inspection the proprietors have had a large number of replacement double glazed windows fitted which has improved the environment for residents. Substantial work has also been undertaken with the home’s electrical wiring and a current safety certificate is now available. This work required a long time to complete and the home has not had the opportunity to provide the Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 16 additional assisted bathroom that was discussed at the earlier inspection, this work remains outstanding. The programme the home had in place for the fitting of thermostatic control valves on all hot water outlets is now complete and this has made it much safer for residents. The outstanding redecoration in the home has not been completed because of all the other work that was in progress. However, as this is now completed it was understood that the redecoration would be undertaken shortly. The residents consulted advised that they liked the facilities of the home and particularly enjoyed their rooms. Ashbourne House DS0000018319.V351166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. The staffing levels at the home are sufficient to meet residents’ needs. Residents are in safe hands and are protected by the home’s recruitment policy and practices. The home has a satisfactory training programme in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ashbourne House has a care team that is up to strength and the care hours available are sufficient to meet the needs of the residents. It was clear from observations made during the inspection that there were good relationships between carers and residents and good-natured banter was overheard. Residents stated that their call bells were always answered promptly and they could get help when they needed it. Three personnel files were examined during the inspection; they had the necessary documentation and complied with the legislation, which ensures residents are in safe hands at all times. Two carers were interviewed during the inspection this was undertaken individually and in private. They advised that they had completed an induction in the home and had received training and understood the adult protection procedure. They were enthusiastic and keen to provide a good service to the residents. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 and 38. Quality in this outcome area is good. Ashbourne House is managed by a person who is fit to be in charge, and can discharge the responsibilities of the post appropriately and residents’ benefit from the approach taken. The financial interest of residents is safeguarded and the health and safety and welfare of residents and staff is given appropriate priority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has had eleven years experience of care and is qualified with NVQ 4 and other qualifications and is completing the registered managers award. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 19 Residents and staff advised that they had a good relationship with the manager of the home and residents felt they were consulted about the issues that affected them in the home. The home has a quality assurance system where residents fill out questionnaires and healthcare professionals are also consulted. The home assists some residents with the administration of their pocket monies, clear recording was in place and all monies that were checked were found to be correct. Health and safety issues are given appropriate priority by the registered manager, the regulations referring to the use and storage of harmful chemicals were in place and appropriate reports were made when incidents occurred in the home. The fire precautions undertaken by the home were well-maintained and clear records kept. The administration of medication undertaken by the home was appropriate and the home has a current installation electrical certificate available. Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 Standard No Score 16 3 17 X 18 3 2 X X X X X X 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 X 3 X 3 X X 3 Ashbourne House DS0000018319.V351166.R01.S.doc Version 5.2 Page 21 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. 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 House DS0000018319.V351166.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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