Inspection on 09/06/08 for Ashbury Court

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Ashbury Court 43 Sea Road Westgate-on-Sea Kent CT8 8QW Lead Inspector Nicki Dawson Unannounced Inspection 9th May 2008 09:45 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 Ashbury Court DS0000070940.V363153.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. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbury Court Address 43 Sea Road Westgate-on-Sea Kent CT8 8QW 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) 01843 834493 Select Healthcare (2006) Ltd Manager post vacant Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (OP) 37 The maximum number of service users to be accommodated is 37. Date of last inspection 27th November 2007 Brief Description of the Service: Ashbury Court provides accommodation and support for up to 37 older people. It is a large semi detached home in the town of Westgate-on-Sea. The home is close to the sea front and many of rooms have a sea view. It is within easy travelling distance of local amenities such as a railway station, bus stops, leisure and sports centres, shops, churches, colleges and local cinema. In December 2007 there was a change in the name of the company that own the home, although the people that own the company remain the same. At this time a new person was appointed to manage the home on a daily basis. This person has is not registered with us to manage the home. The fees for support from the home vary according to the individual needs of the service user. The home manager stated that the average fee levels at this time are £320.81 to £550.00 per week. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced, which means that the service users, staff and home manager did not know that the inspectors Nicki Dawson and June Davies were calling at the home. The inspection started at 9.45am and took just under 7 hours. Discussion took place with service users, staff and the home manager, to gain their views and knowledge of the level of care, provided by the service. All rooms on the first floor were entered, including resident’s bedrooms. A number of records to do with resident’s care and safety were looked at. A statutory enforcement notice was served on the registered individual in December 2007 due to 10 unmet requirements. The home sent the commission a plan of what it is doing to improve the service and meet the outstanding requirements. This inspection focused on assessing whether the home has done what it said it would do in the improvement plan. Survey questionnaires (“Have Your Say About...”) were sent by the commission to the home before the inspection visit. These comment cards are useful in gaining the views of the people who live and work in the home about the quality of care that is provided by the service. Two comment cards were returned from relatives. One was very positive about the support that was provided by the home and the other that “promises are not always honoured”. What the service does well: What has improved since the last inspection? The home has improved in all necessary areas to meet the unmet statutory requirements that were made at the inspection six months ago. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 6 Service users have benefited in a number of areas: Their needs are now fully assessed before they move to the home, so that they can be sure that they can be met. Any personal support that they receive is recorded so that it can be certain that it is consistent. They have regular access to a chiropodist so that their feet and hands are well looked after. If they fall they are monitored so that action can be taken to help minimise the frequency of any further falls. A procedure is now in place to record and investigate any complaint that they make. The number of care staff on duty in the morning has increased so that service users receive the attention that they need. The environment has improved in that the garden area has been made safe so that service users can benefit from it in the summer weather. Doors are no longer being wedged open, which could have aided the spread of a fire if it had occurred. Staff benefit from being managed by an experienced person who supervises them regularly to develop their skills. They will benefit further in meeting the needs of the service users, once they have completed the programme of training that is on offer to them. 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. Ashbury Court DS0000070940.V363153.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 Ashbury Court DS0000070940.V363153.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 4 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are fully assessed before they move into the home so that they can be sure that they will receive the right type of care. Residents who have additional learning disabilities cannot be assured that their needs will be met. EVIDENCE: Before new service users are admitted to the home a full needs assessment should be carried out to decide whether or not the home is a suitable place for the person to live. At the last inspection it was found that insufficient information was being obtained to make this decision. The appointed manager said that she aims to meet the prospective resident in their own home to carry out an assessment of their care needs and that she is using a new tool to do so. The assessment of one resident that has recently moved to the home was Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 9 looked at. It gave good information on which to base an assessment as to whether the home could meet this persons needs. This information is used to start the development of an individual plan of care. If the person is funded by the local social services, then a copy of the social services assessment is obtained from social services. The main aim of the home is to care for the needs of older people. The home has recently admitted a number of residents who have the additional need of a learning disability. Staff are not able to communicate with one resident. Only the appointed manager has had the appropriate training and experience to meet the needs of these learning disabled residents. It is recommended that the whole staff team receive training in this area, particularly to meet the needs of one resident who has a specialist communication need. Ashbury Court DS0000070940.V363153.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 - 10 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Not all service users benefit from having a plan of care that gives clear guidance to staff as to how to meet their assessed needs. Service users’ access to health care services is improving, but their health care needs are yet fully met. Service users are treated with dignity and respect and their privacy is maintained. EVIDENCE: Each service user should have an individual plan of care that clearly sets out their health, personal and social care needs, together with the staff support Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 11 that is required to meet these assessed needs. Four service users’ care plans were examined. The quality of the information recorded in each plan varied greatly. Two care plans clearly set out the action that staff need to take to meet the service users’ care needs, but the other two care plans did not. For example, one service user is assessed as being physically aggressive, but there is no plan in place to guide staff what to do if this person is aggressive. Care plans had been regularly reviewed, but had not been signed by the resident or their relative to show that they had been involved in developing and reviewing their plan of care. Care plans cannot be used as a daily guide for staff since they contain a lot of complex information and are kept in the office. All care plans should have written plans in place to minimise the effect of any potential risks. Some plans did not contain useful guidance for staff. For example, the guidance in one risk assessment is to ‘encourage’ the service user, but it does not clearly detail how to do this. For a service user using cot sides, valid consent had not been obtained from the resident’s relative and appropriate health professional. This consent is needed or the practice could be seen as form of abuse, in limiting the person’s freedom of movement. The appointed manager said that she would review the information and location of each service users’ plan of care to make sure that they are fit for the purpose for which they are intended. Service users care plans have improved by each containing a personal hygiene matrix. When a member of staff carries out a personal care task it is recorded to make sure that all areas of personal care are met on a regular basis. A record is kept if a service user has an accident or fall. A falls monitoring form has now been introduced and service users are risk assessed if they fall regularly. Since this has been in place the number of falls that residents sustain has reduced. The current level of risk of a service users’ mobility is indicated by a colour code on each service users’ bedroom door, which guides clear guidance to staff. The appointed manager said that all service users are supported to visit health care professionals to maintain their health. Service users now have regular access to a chiropodist. However, only one service user visits the dentist. The appointed manager said that she would consult with service users so that they have access to a dentist of their choice. The home uses a pre-dispensed system for administration of medicines. This system is used to reduce the risk of service users receiving incorrect doses or incorrect medication. The person that is giving out the medicine records on a Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 12 pre printed form the medicine has been given or, if it hasn’t been given, the reason why. On examination of this record it was found that there was one gap in recording medicine so that it was not clear if the service user had received their medication. Twelve service users did not have all or part of their medication signed in on the record and one liquid medication was not dated on the day that it was opened. Without this information an audit trail cannot be kept of all medicines that come into and leave the home. A bottle of eye drops was kept in the fridge when the information on the medicine said that it should be kept at room temperature. The eye drops had exceeded the use by date and therefore may not be as effective as is intended when it was prescribed by the GP. The record kept of controlled drugs contained the service users name, but not the name of the medication that was being given and therefore is not a reliable record. During the visit staff were observed talking with service users in a respectful and individual way. They were seen knocking on bedroom doors before entering and closing doors to maintain their privacy. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are able to choose their life style and to keep in touch with family and friends. Service users enjoy mealtimes and receive a healthy and varied diet. EVIDENCE: Staff support service users who are in the lounge area to take part in activities such as bingo, singing, gardening and reading and writing. A lady visits the home to offer exercise twice a week. The appointed manager said that outside entertainers are booked monthly. Each service user has a record of the daily activities that they take part in. Staff said that they are encouraged to spend time talking to the service users. The appointed manager said that a part-time activities coordinator is due to start soon to offer a more individual programme of activities. One service user said, “there are activities on offer. I don’t usually join in because I like to go out to the shops”. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 14 Visitors came and went from the home on the day of the inspection. Service users confirmed that family members are able to visit them at any reasonable time. Occasionally staff take the residents’ out for a walk along the sea front and on shopping trips. The pace of daily life in the home is relaxed and unhurried. Service users are able to choose when to get up, when to go to bed, what to wear, what to eat and how to spend their day. Service uses said that the standard of food in the home has improved since a new cook as been appointed. One service user commented that the food, “is lovely now and you know how fussy I can be”. And another, “we are given choice. I could have had fish or fried egg today, but I chose fried egg. You taste it!” The daily menu is on display in the dining room. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are confident that any compliant they make will be listened to and procedures are now in place to make sure that it would be resolved to their satisfaction. Staff feel confident to speak out and take action to protect service users, if they have any concerns about their care. EVIDENCE: Neither the home nor the commission have received any complaints about the service in the last six months. Details of how residents or their relatives can make a compliant about the service are displayed prominently in the home. The appointed manager has introduced a new procedure to record, investigate and respond to any complaints that may be made. Service users who commented, said that they knew how to make a complaint. One service user said, “If I had a complaint I would take it directly to Diane, the manager. There are some staff I would tell, but there are some I would not”. Another said, “If I had something to gripe about I would talk to a member of staff, or Diane when she comes to see us”. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 16 Service users who wish to are supported to vote in local elections. Information is available in the home about how service users can contact advocates who will act in their interests. Staff have a good understanding of what is good care practice. The home manager states that some care staff have received formal training in safeguarding vulnerable adults. More training is planned for staff in the next month. Staff said that if they saw any form of abuse taking place in the home, that they are confident to tell the member of staff to stop and to report the incident to a more senior person on duty. One member of staff said, “If you don’t stand up to them, you are as much at fault as the person who is abusing”. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Services users do not benefit from living in a home that meets their expectations of being clean and well-maintained. EVIDENCE: The home has been required to make sure that a decoration and refurbishment programme continues to be undertaken throughout the home, since July 2006. A number of service user rooms and communal areas have been painted and decorators were undertaking further works on the day of the inspection. The appointed manager said that she has informed company of all the areas that need improvement and some new furniture is on order. However, there are still a number of areas in the home that do not fit with the expectations of providing a dignified environment for the service users who live in the home. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 18 One service user room that has been redecorated had a stain on the wall and another that had been redecorated had marks on the wall, even though the room had not been used. The furniture in some service users’ bedrooms is worn and need replacing. For example, when the top draw was opened on a chest of draws, the draw front fell off. The appointed manager said that some sets of furniture for service users rooms are on order. Service users do not benefit from all the facilities that are on offer in the home. The seals on the windows in the smoking room are broken so that service users cannot look out and enjoy the sea view. The conservatory blinds are not effective so that the room is too hot for service users to sit in comfortably. One service users bedroom window looks out onto a storage area that is used by the company’s head office. Although there are net curtains on the window to try and maintain the person’s privacy, the use of this area prevents the service user from being able to look out at the views from their window. Service users who have baths in their rooms are not able to use them. This is because the water temperature has not been regulated to a safe temperature for them to bathe and therefore the water has been turned off. The thirty seven service users in the home only have the use of two bathrooms and one wet room. The home is required to continue to provide at least one assisted bath or shower for every eight service users that live in the home. The home has improved by clearing the garden of rubbish. A fence has been placed at the bottom of the garden so that service users can enjoy the environment in safety. However, one courtyard has some rubbish collecting in it. This rubbish has come from the top of the building where the company’s head office is located. This is not acceptable and it indicates that the people who work for the company do not respect the dignity of the people that live at Ashbury Court. Radiators have been guarded to minimise the risk of scalding if a resident falls. Service users bedroom doors now close automatically in the even of a fire, and hence minimise the risk of the fire spreading. Service users are provided with call bells so that they can call for assistance when needed. However, it was found that there was no call bell in one of the ground floor toilets. Some call bells in service users rooms and one located in a toilet are kept where service users cannot reach them if they need assistance. It was observed that service users have aids to help them mobilise around the home. Some aids that are no longer in use are stored inappropriately in the hairdressing room. Work has started but not been finished with regards to putting up handrails in the corridors of the home, to help service users who need assistance. The appointed manager said that the advise of an occupational therapist has not been sought in assessing the home’s facilities for meeting the needs of service users with mobility difficulties. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 19 Service user’s relatives commented that the home was clean. One relative said, “the cleaning staff are excellent”. However, the home was not clean on the day of the inspection. For example, the extractor fan in the smoking room was covered in grim. The floor in the hairdressing room was dirty. There were dark stains around the bottom of one toilet, one toilet was stained inside, two were not clean, and one had a seat that was not securely fixed. Two rooms had a smell of urine, even though the appointed manager said that they had had their carpets deep cleaned. The appointed manager said that she plans to employ an additional cleaner and to re-examine the home’s cleaning programme to improve the environment for service users. The home is not doing all that it can to minimise the spread of any infection. For example, one clinical waste bin had not been emptied regularly. Used gloves were placed in an open topped bin the lounge. The seal around the hand washing sink in the kitchen was broken. Although staff that spoke to the inspector were knowledgeable about how to minimise the spread of infection in the home, not all staff have received up to date training in this area. It was also found that the kitchen has flaking paint on the ceiling. This paint could potentially fall off into any food that is being prepared in the area. There is no written plan in place to address the shortfalls mentioned above in this report. It is required that a plan of action is submitted to the commission with estimated timescales for completion so that the home is maintained to provide a safe and dignified environment for the people who live there. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 20 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): 27-30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is enough staff on duty to meet the needs of the service users and a staff training programme is being developed to make sure that these needs are met in a satisfactory way. Recruitment practices within the home are good ensuring that service users are protected from potential harm. EVIDENCE: The number of care staff on duty in the morning has increased from four to five since the last inspection. There are four care staff available in the afternoon and three waking night staff. Staff said that they now have enough time to spend one to one time with service users. Each day a cook and assistant cook prepare meals for service users and a person is available to launder their clothes. Service users were generally positive about the support that they receive from staff. “One or two are still miserable, and you hardly get a word out of them, but I do not have much to do with them, most of the staff are O.K. and we have a good laugh sometimes”. 50 of staff are trained to National Vocational Qualification (NVQ) level 2 or above. This award is useful because it helps staff develop good care practices Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 21 and their skills in working with people who live in a residential care home. Before new members of staff are employed at the home a number of checks need to be carried out to make sure that all members of staff working at the home are suitable to care for vulnerable service users. Files were seen for two new members of staff and for three members of staff who had been employed at the home for some time. All the relevant checks and documentation including Criminal Record Bureau enhanced disclosures, two references, contract of employment and application form were included showing that the recruitment process followed protects the service users. There is a checklist on the front of each file showing the information that should be included. This is a valuable way of making sure that all staff files contain the information that is needed. The appointed manager is responsible for making sure that care staff have the skills they need to support the residents who live in the home. The appointed manager said that all new care staff receive the appropriate introductory training, which gives them the basic competencies they need to be able to work without direct supervision. In addition to the introductory training, care workers undertake a number of training courses that develop their skills in caring for the people that live in the home. The appointed manager has completed a staff training matrix, which identifies the training that each member of staff needs to achieve. There are a large number of gaps in this record indicating that no member of staff is currently up to date with their mandatory training. The appointed manager said that she aims to train all the staff team in the necessary areas by the end of August. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 22 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, 36 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from the management approach of the home, which is individual and open. Progress is being made towards seeking the views of service users and visitors to the home so that the home can be run in service users best interests. Action is being taken to make sure that the health, safety and welfare of service users is promoted at all times. EVIDENCE: Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 23 The appointed manager is responsible for the day to day running of the home. She has been employed at the home for five months. She has sixteen years of experience of working with older people and people with learning disabilities in the community and residential settings, including a number of management positions. The appointed manager has both of the formal qualifications specified by the National Minimum Standards. These awards are recognised by the commission to be useful because they help to make sure that people who manage residential care services have the competencies that are necessary to do so. The appointed manager said that she would shortly be applying to the commission to become the registered home manager. Service users were observed talking with the appointed manager in an easy manner. One service user said, “The manager is a very nice person, always bright and cheerful, and you can see the difference in the staff since she came to work here, they are much brighter too”. Staff said that the appointed manager was approachable and that she had made a number of changes for the better. “She stops and listens; not see me later”. For the home to run in the best interests of the service users it is important to have a system in place which regularly obtains the views of service users and visitors about the standard of care that they receive from the home. The appointed manager was able to show that the home does have questionnaires for the residents, and visitors such as relatives and care managers. She said that she was awaiting further responses before she looks at the information received and acts to make any changes necessary to improve the service. In addition to this formal system, the appointed manager said that she speaks to every service user weekly to make sure that their needs are being met. The appointed manager has started to monitor systems used in the home to make sure that they are effective. However, this does not currently include areas that have been identified in this report as needing improvement, such as care plans, risk assessments, and the cleaning in the home. Service users are given the choice of managing their own personal allowance when they come to live in the home. The home assists some of the service users with their weekly monies. These records were examined on the day of the inspection. However, when they were examined at the last inspection, they were well organised. Staff meetings now take place for all care staff to help better communication between everyone involved. The appointed manager has started to supervise Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 24 all members of staff to give them the opportunity to discuss care practice and to identify and develop their skills for caring for the people who live in the home. The appointed manager said that all items of equipment in use in the home remain in good working order. Certificates looked at for electrical installation, gas appliances and the mobile hoist confirmed that these had been serviced at the correct intervals. There were requirements made at the previous inspections for the fire system to be properly maintained and for a Legionella assessment to take place. This has now been complied with. Environmental risk assessments have been carried out to make sure that the home is as safe as possible to the people who live in it. This assessment does not currently include any potential risks to service users in their own rooms such as the risk of falling out of an open window. The appointed manager said that she would extend the content of the risk assessment to include service users bedrooms. As mentioned previously, the appointed manager has developed a staff training matrix to identify the staff training needs of the whole team. She is aware that most staff’s training is out of date and plans to make sure that all staff are trained in the necessary areas of fire, health and safety, first aid, moving and handling, infection control, and safeguarding adults in the next four months. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 25 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 2 X X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 2 3 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13 (2) Timescale for action The registered person shall make 02/07/08 arrangements for;Recording the amounts of all medicines received into the home; Recording the names and dosages of all medicines in the controlled drug book 2 OP19 23 (2) (c) (d) (j) 28/06/08 The registered person shall having regard to the number and needs of the service users submit an improvement plan to the commission detailing by what means and in what timescale they will ensure that; - equipment such as furniture provided at the care home for use by service users is in good working order; - all parts of the home are kept clean and reasonably decorated; - the number of assisted baths Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 27 Requirement and showers fitted with a hot and cold water supply that were provided in August 2002, are reinstated . 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 OP4 Good Practice Recommendations Training in how to meet the needs of residents with learning disabilities and communication difficulties should be provided to all staff that work with people that have been assessed as having these needs. Ashbury Court DS0000070940.V363153.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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