Inspection on 05/01/06 for Ashbourne Nursing Home

This inspection was carried out on 5th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Nursing Home 17/01/08

Ashbourne Nursing Home 09/11/06

Ashbourne Nursing Home 02/12/04

Ashbourne Nursing Home 03/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashbourne Nursing Home Ashbourne Street Norden Rochdale Lancashire OL11 5XF Lead Inspector Bernard Tracey Unannounced Inspection 5th January 2006 09:30 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 Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashbourne Nursing Home Address Ashbourne Street Norden Rochdale Lancashire OL11 5XF 01706 639944 01706 860629 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) Bamford Care Limited Richard Lake Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 43 service users to include:up to 43 service users in the category of OP (Older People) The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 7th June 2005 Date of last inspection Brief Description of the Service: Ashbourne Nursing Home is a privately owned care home providing nursing and personal care for older people. It is situated in the village of Norden two miles from Rochdale town centre. Accommodation is provided in 41 single and 1 double room, 9 of the single rooms have en- suite shower and toilet facilities. A large communal area provides the lounge and dining facilities from which access to the garden and patio area is available. A car park provides space for 12 cars and further car parking is available in the lane at the side of the home. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Ashbourne House is privately owned by Bamford Care Limited and is registered with the Commission for Social Care Inspection to provide personal and nursing care to male and female residents over 65 years of age. The home had not been told beforehand that the inspector would visit. The inspector looked around the building and looked at paperwork about the running of the home, how staff were recruited and the care given. During the inspection six of the residents, one visitor, one senior carer, two care assistants, one nurse, the manager, and the administrator were spoken with. Carers were observed as they went about their work A total of 4.5 hours were spent at the home. The last inspection took place on the 7th June 2005. What the service does well: What has improved since the last inspection? The management team have continued with their refurbishment programme particularly in relation to personal accommodation. The management team continue to work towards achieving consistently high standards of care and have staff and residents meetings to create and launch new ideas. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 4 5. Standard 6 does not apply A range of information is available which enables service users to make a fully informed choice about where they would like to live. Residents are assessed before entering the home to be certain that the home can meet their needs. EVIDENCE: When a prospective client contacts the home a brochure is sent out to the enquirer that describes the homes purpose and function. To ensure the person has a realistic view of life in the home they are free to visit at any reasonable time. Where possible the prospective client can spend some time with other residents and also have a meal with them. A resident said that his daughter arranged everything for him coming to the home and that he came straight from hospital. Examination of five residents’ care files showed that detailed assessments Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 9 had been completed for each resident prior to their admission to the home. Following admission, assessment continues and the files set out the normal routine for residents and their additional care needs. Staff said the manager or his deputy undertakes the pre-admission assessments and an individual’s care needs would be discussed and explained to staff before they arrived at the home. Staff are also encouraged to read the care plans, and receive a handover from the nurse in charge at the beginning of each shift so they are updated with any changes to care. Staff spoken to knew the residents well, understood their care needs and were able to describe their usual routine. Residents and relatives spoken to stated that staff were aware of what they could do for themselves and what they needed help with. After a six week trial period each resident is given a contract that specifies the terms and conditions of living in the home. The contract includes who pays the fees, by whom and when they are paid. It also describes the care that is includes in the fee. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 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 The care planning system does not always provide staff with adequate information to meet residents needs and therefore fails to ensure that all the health care needs of residents are identified and met. The home is not consistently good at involving residents or their representative in the development or review of care plans. The homes procedures for storing and administering medication are sufficiently robust to safeguard residents. EVIDENCE: Individual records are kept for each resident. From the information gathered, an individual plan of care is drawn up. Significant events had been recorded and daily entries made setting out the care given. In the main, the care plans detail the physical, social and mental health needs of the resident as identified by staff using the information supplied by care managers, as well as the home’s own assessment. However, two care plans did not clearly indicate how an individual’s care needs were to be met in Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 11 relation to care during the night hours and also care for an individual with a catheter. Evidence was seen of the monthly reviews carried out to ensure that the care plans continue to meet individual needs. There was clear evidence of the involvement of the Mental Health services in the planning and review of individual care, where appropriate. Not all care plans provided written evidence of residents or their representatives being involved in the drawing up and review of individual care plans. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure care. The residents were weighed at least on a monthly basis and the weight recorded on a chart kept in their care plan. A discussion with the residents identified that they had access to other health care professionals, such as dentists, opticians, chiropodists and district nurses. Evidence of these visits was kept in the residents’ individual files. Medical examination and personal treatment is provided in the privacy of the resident’s own room. There is always a Registered Nurse on duty in the home; the deputy matron has the delegated responsibility for ordering the monthly prescriptions. Due to the recent changes in the procedure for returning drugs to local chemists a system to deactivate drugs on site has been implemented. This procedure is safely managed with the support from a company that the home has engaged to oversee this process. The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an accurate record of medicines received into the home and returned back to the pharmacist. Designated and appropriately trained staff administered medicines. It is recommended that when it is necessary to hand transcribe prescriptions on to the medicine administration sheet, the entry is checked and signed by two members of staff to avoid errors. All the residents spoken with said they felt the staff looked after them well, and that staff helped them if they needed it. One resident who had recently been admitted described how anxious she felt because she ‘needed a lot of help as she had now spent all of her time in her wheelchair and could no longer do the little things that you take for granted’ but said the staff treated her with respect and he felt her personal dignity was maintained. They also discussed with her the times that were best for her to get up in the morning and get ready for the day ahead and always helped her when required. Another resident said the staff were always happy and helpful and she was never made to feel embarrassed when needing help going to the toilet or when she needed assistance with her personal care. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 12 Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 13 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 Social activities provide daily variation and interest for people living in the home. Residents are able to make positive choices about how they spend their day and friends and families are very much a part of this process. EVIDENCE: The resident’s involvement in social activities varies greatly according to their abilities and nursing needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The home employs an activities person who organises events and activities within the home as well as trips out to various places of interest. The programme of activities was displayed in the reception area and in other strategic places throughout the home, so that residents were aware of what was “going on”. Apart from details about games, quizzes and activities it also gave information about how often religious services would be held. There was also information about when the hairdresser and chiropodist would be visiting. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 14 When discussing life in the home with some residents, they confirmed, “I Please myself when I get up on a morning and when I go to bed”. I asked a resident if he had read his care plan but was told “I leave that up to the staff” but said “I suppose I could if I wanted too”. Several residents said they were happy for their relatives to deal with money matters. The manager has a range of information available for residents and the notice board in the reception area was up to date and displayed information and telephone numbers for the Advocacy service and the CSCI local office. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 15 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 18 There is evidence to show that residents and relatives were able to make their concerns known and they would be acted upon. Staff had a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse to residents. EVIDENCE: The home has written policies on Adult Protection and Whistle blowing, which staff were aware of. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with care staff and management identified that there were very aware of the procedure to follow in the event of any allegation of abuse. All members of staff had undertaken training in the protection of vulnerable adults or were scheduled to attend further training in March 2006. The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to said they would be happy to tell the staff if they were concerned about anything in the home and felt this would be listened to and acted upon. There have been two anonymous complaints received since the previous inspection, both in respect of perceived low staffing levels, but following investigation by the Commission both were not proven. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 16 Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 17 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): The key standards were examined at the last inspection The standard of furnishing and fittings within the home was generally good providing a homely, safe, well adapted, clean and comfortable environment for residents. EVIDENCE: The key standards were examined at the last inspection on the 7th June 2005. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 18 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 procedures for the recruitment of staff do not provide the safeguards to offer protection to people living in the home. Records for staff training need to be more accurately maintained to ensure that the home can identify the staff who have received the relevant training to meet the residents needs. EVIDENCE: A recruitment system is in place and the records are well maintained. Each staff member has a personnel file that is kept in accordance with data protection. To ensure the residents are safe each employee completes an application form and explains any gaps in employment. Two references are requested by the manager, one of the references is from the previous employer. Photographic identification and birth certificates are copied. One file examined did not provide evidence that the home had sought a criminal records check at an enhanced level or that a check had been made against the Protection of Vulnerable Adults list before employing the individual. Nurses personal identification numbers are checked with the Nursing & Midwifery Council to ensure the nurses are eligible to practice. The home can demonstrate it’s commitment to training and there is a training Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 19 plan which includes a range of subjects such as health and safety, basic food hygiene, fire training, first aid. Records of staff who have received training or for whom training is planned needs to be more accurately maintained. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 The home is well managed and run in the best interests of residents. EVIDENCE: The manager is a qualified nurse who has many years experience in caring for residents and possesses a management qualification. Throughout the inspection the Inspector was able to observe the professional, capable and approachable manner in which the manager undertook his role when dealing with residents, staff and visitors. Residents, relatives and staff spoke well of the management team and the care and support that they give. Staff said that the manager provided a clear sense of leadership. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 21 A quality assurance system is in place and a survey that includes residents and relative’s opinions. The manager audits all of the services offered in the home annually and any areas that do not meet the homes standards are addressed within a reasonable time scale. This home has a joint relatives and residents committee that is also involved with fund raising and the committee promotes the well being of the residents. Residents and staff meetings are held regularly to share information and also to listen to people’s views about the service that is offered. Maintenance certificates were up to date to show the equipment in the home is serviced regularly and safely maintained. Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 22 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 23 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 Timescale for action 28/02/06 2. 3. 4. OP7 OP30 OP18 15 12 19 All residents must have a care plan that sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health personal and social care needs of the individual are met. All care plans must be drawn up 28/02/06 with the involvement of the resident and their representative Evidence of completed training 28/02/06 must be held on staff files. POVA and CRB checks must be in 28/02/06 place prior to staff beginning work at the home. 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 OP9 Good Practice Recommendations Hand transcribed medication should be witnessed by two staff members to avoid errors. DS0000017314.V268765.R01.S.doc Version 5.1 Page 24 Ashbourne Nursing Home Ashbourne Nursing Home DS0000017314.V268765.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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