Inspection on 09/11/06 for Ashbourne Nursing Home

This inspection was carried out on 9th November 2006.

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 Nursing Home 17/01/08

Ashbourne Nursing Home 05/01/06

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 9th November 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.V298281.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 Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 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.V298281.R01.S.doc Version 5.2 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. 5th January 2006 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. The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody £ 7.00 Hairdressing £3.75 to £18.00 Newspapers As charged Fees charged by the home provided in October 2006 are in the range of: £331.00 to £536.00 Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and community nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. Six residents and two relatives responded and their views have been included throughout the report. The questionnaires sent to visiting professionals asked questions relating to communication, availability of senior staff when visiting, staff having a clear understanding of service users needs, management taking appropriate decisions, management of medication, complaints from residents they may be aware of, and if they are satisfied with the overall care provided by the home. Only one reply was received and from a doctor who praised the home for “the way they communicated and for the care provided by the staff to the client” The Inspector spent 6.5 hours at the home. During this time he looked at care records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken as the home and time was spent looking at records regarding safety in the home. He also examined files that contained information about how the staff were recruited for their jobs, as well having a discussion about staff training. The Inspector spent time speaking to 6 residents as well as speaking to 2 relatives, 6 staff, and the manager. What the service does well: The assessment and ongoing review of care is thorough, which makes sure that the residents’ care needs are being met. The care plans are well written and contain details of any specific intervention required. All care plans are reviewed monthly or more frequently if there are changes to the needs of the residents. Before coming to live at Ashbourne Nursing Home, every resident is visited, either at home or in hospital, to make sure the home can meet his or her needs Many of the staff had worked at the home for a long time and the residents said that they liked the staff and felt safe in the home. Comments such as “they are lovely girls”, “I am very happy here” “I am glad I moved here” were made to the inspector. One relative said that the staff “were very good indeed” . One relative stated “The staff are wonderful. They are always there for the Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 6 residents and keep me informed of any changes to my relative’s care.” The home is managed to a high standard and the staff morale is high. 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. The summary of this inspection report can be made available in other formats on request. Ashbourne Nursing Home DS0000017314.V298281.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 Nursing Home DS0000017314.V298281.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): Quality in this outcome area is good Admissions are not made to the home until a full needs assessment has been undertaken. The home are then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the Statement of Purpose. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, either by a senior member of the nursing staff from the home or from the professional i.e. Rapid Response Nurse requesting their admission. The assessment documents of three residents were looked at. The assessments were detailed and gave a clear indication of the residents’ needs and their capabilities. The assessments looked at the physical, mental and social care needs of the residents as well as the involvement if any, of their relatives. The Inspector spoke with the relatives of a resident who had recently been admitted, who stated that the manager had been out to the Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 9 residents’ home to undertake an assessment of her needs and also provided information that helped them to come to the decision that the home would be able to meet her needs. All of the questionnaires returned to the Commission confirmed that each individual felt that they had received enough detailed information prior to making a decision to come into the home. All residents spoken with stated that they had received a contract from the owner that describes the terms and conditions of their stay. Ashbourne Nursing Home DS0000017314.V298281.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): Quality in this outcome area is good Residents’ health and personal care needs are being met and are addressed in detailed care plans. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has reviewed and, where necessary, rewritten the care plans for all residents since the last inspection. The care plans are now extremely informative to enable staff to identify with residents specific care needs, together with their preferences, likes and dislikes. All health, social and emotional care needs are identified and individual care plans are prepared for each of the identified need. The care plans are signed to confirm agreement with them. Relatives spoken to on the day of the inspection confirmed that they had discussed the care plans with the manager or nurse and were able to discuss the resident’s preferences in relation to meals, times of going to bed and getting up and how the service users like things done. Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 11 Risk assessments are undertaken on all residents in relation to daily living and appropriate measures are put in place to reduce or remove any potential risk. These are recorded in the care files and the agreement of family members is obtained for the use of bed rails and for the use of any other protection equipment. All care plans and risk assessments are reviewed on a monthly basis, or as changes in care needs are identified, and these are updated as appropriate. Staff actively promote the resident’s right of access to the health and remedial services that they need, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Staff keep a regular check on health aids, making sure they are working effectively and that each resident has the necessary aids to improve their quality of life. Records held in the home provide evidence of the input by other healthcare professionals and advice is sought from District Nurses and the Tissue Viability Specialist Nurse as necessary. Residents have choice over their personal care and are encouraged to be independent and responsible for their own personal hygiene where possible. The home has a robust medications policy and inspection of the medications records provide evidence that the staff follow the procedure. All records relating to medications were found to be well maintained and up to date. The medications room and trolley were seen to be clean and organised. Appropriate arrangements are in place for the disposal of unwanted medications through a contract with a disposal company. Visitors confirmed that the residents were treated with respect and in a dignified manner at all times. Privacy is respected at all times. Residents are free to meet with their visitors in the privacy of their own bedroom or in one of the communal areas. Visitors confirmed that they were welcome to visit the home at any time and that the staff were approachable and available to speak with them whenever they wished. One visitor said that it was lovely that the staff were forthcoming with updates of their relatives care without having to ask. Visitors spoke highly of the manager, the care and ancillary staff and commented on how committed and caring they were. Comments from residents regarding the care include: “Staff are excellent” “The care is really good and I feel really safe here” Ashbourne Nursing Home DS0000017314.V298281.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): Quality in this outcome area is adequate Social activities do not 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently appointed a new activities co-ordinator Residents’ social and leisure preferences are not always recorded in their care plans. In the care files, which were read, these documents had not been completed so it was not possible to fully assess the level of social stimulation on offer for individual residents. The home has recently appointed a new social activity co-coordinator who is in the process of gathering information from each resident about their likes and preferences in relation to interests and activities and following this she will be in a position to provide both group and individual programmes. On the day of the inspection a game of musical bingo was organised followed by a demonstration of flower arranging by a visitor from the local church. Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 13 Residents rights to follow and practice their religious beliefs are acknowledged and well promoted. The home also holds details of Ministers Religions who can be contacted to provide services for residents if they are not of the Christian Faith. The home does not have any religious persuasion. Feedback from relatives was positive with regard to arrangements for visiting. They said they could visit whenever they wished through the day and evening and were made to feel welcome. This was consistent with the visiting policy stated in the Statement of Purpose. Visitors had a choice of where they met with relatives – either in their bedrooms, the lounge or the dining room. Menus inspected were seen to provide a balanced, nutritious and varied diet over a 6 week period. All food was ‘home-cooked’ which residents said they appreciated. Little wastage was seen at the end of the lunchtime meal. Residents spoken with all said they enjoyed the food. Observation when meals were being served showed that the cook knew individual’s likes and dislikes. . Suitable provision was made for those needing special diets i.e. diabetic and soft diets. The cook ensured diabetics were offered as much choice as other residents by using sweeteners in desserts. Staff gave appropriate assistance to those needing it. Ashbourne Nursing Home DS0000017314.V298281.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): Quality in this outcome area is good Residents and relatives have confidence that their concerns will be dealt with. Abuse policies and procedures are in place to protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaint procedure is on display and residents and relatives interviewed were satisfied with all arrangements in the home and were aware of how to make a complaint if needed. A staff member said, “If a resident wanted to make a complaint, I would go to the nurse in charge or the manager”. The complaint log was seen and complaints recorded related mainly about lost clothing and other personal possessions. All of these complaints appeared to have been dealt with satisfactorily. One detailed complaint about the care and personal needs of a resident had resulted in a meeting with the resident’s family, the social worker and the home manager. The Inspector was informed that this complaint had now been resolved satisfactorily. The home has a copy of the Rochdale Guide for the Protection of Vulnerable Adults and staff have undertaken training in relation to the Protection of Vulnerable Adults. The home also has an abuse policy and whistle blowing procedure. The staff training record evidenced abuse awareness training for a number of staff and staff interviewed had an understanding of how to report an alleged incident. Ashbourne Nursing Home DS0000017314.V298281.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): Quality in this outcome area is good Residents live in pleasant, safe, comfortable and well-maintained surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built and accommodation is provided on two levels. It is fully accessible to people who are physically disabled and is fitted with aids and adaptations to promote independence. The main entrance hall is spacious and there is ample information available regarding the home and the service it provides. The home is well maintained, decorated to a good standard and was clean and tidy during the site visit. There is a garden and car parking space to the front and the home has a central patio area with easy access on all sides of the home. The patio is equipped with patio furniture and sun umbrellas. Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 16 A partial tour of the building was undertaken, two bathrooms, a shower room and six bedrooms were viewed. The bathrooms were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. Bedrooms viewed had individual items and were homely. A resident said, “I have everything I need, including some of my own furniture”. Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. The home is equipped with comfortable furniture, fittings and electrical equipment, including a computer. The home has a well equipped laundry and there was evidence of gloves and aprons for staff use. Infection control training is given to staff and infection control policies are available. Residents commented on the good laundry service. Fire risk assessments of the building are in place and emergency lighting is provided throughout. The grounds were tidy and accessible to residents. CCTV cameras are in operation at the entrance of the home to monitor security. Ashbourne Nursing Home DS0000017314.V298281.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): Quality in this outcome area is good. There are appropriately trained and experienced nurses and care staff employed so that residents feel supported and that their needs are understood and met. The home’s recruitment policy is generally robust to protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing rota for the month of October 2006 was viewed. Sufficient numbers of staff were on duty at the time of the site visit to care for the resident and the staff team comprised of seven care staff, the manager, two registered nurses, a maintenance man, domestic catering staff and an administrator. The home has a stable workforce and a number of staff have worked at the home for many years. Staff were complimentary regarding the support they receive from the manager. Residents interviewed described the staff as “caring”, “helpful” “good company”, “Polite and all the members of staff support us and each other in a wholly admirable way”. The home has a rolling programme for staff training and a training matrix viewed evidenced courses attended in safe working practices including, fire prevention, infection control, first aid and health and safety. Food hygiene has been booked for later this year and a further first aid course Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 18 planned. Staff attend abuse awareness training and other courses relevant to the older person. Updates in manual handling were required. A staff member said, “The home offers good training”. A high percentage of staff have attained a National Vocational Qualification (N.V.Q) Level 2 in care and NVQ Level 3 is also being accessed. Staff interviewed stated that they had received an induction. Four staff files were viewed with regard to recruitment practices and these evidenced the necessary checks to protect the residents. Staff had completed a job application form and references had been obtained. CRB enhanced disclosures are obtained for staff. A record is made of the date the CRB is sent off and received. Staff receive contracts of employment. Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The home is well managed and run in the best interests of residents. This judgement has been made using available evidence including a visit to this service. 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.V298281.R01.S.doc Version 5.2 Page 20 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.V298281.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 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.V298281.R01.S.doc Version 5.2 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 OP12 Regulation 16 Requirement Activities suitable to the needs of residents must be regularly provided, recorded, monitored and reviewed. All staff are to receive training in safe moving and handling techniques Timescale for action 30/12/06 2. OP30 18 30/12/06 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 Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 23 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: 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. Extracts may not be used or reproduced without the express permission of CSCI Ashbourne Nursing Home DS0000017314.V298281.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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