Inspection on 02/11/06 for Ashbury Lodge Residential Home

This inspection was carried out on 2nd 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

Ashbury Lodge Residential Home 17/11/05

Ashbury Lodge Residential Home 07/06/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Ashbury Lodge Residential Home 261 Marlborough Road Swindon Wiltshire SN3 1NW Lead Inspector Alyson Fairweather Key Unannounced Inspection 10:00 2nd November 2006 and 8th December 2006 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 Lodge Residential Home DS0000057248.V317781.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 Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbury Lodge Residential Home Address 261 Marlborough Road Swindon Wiltshire SN3 1NW 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) 01793 496827 01793 525953 coatewatercare@aol.com Coate Water Care Company Limited Mrs Geraldine Frances Smith Care Home 44 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (25), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (25), Old age, not falling within any other category (19), Physical disability (1) Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The only service user in the age range 18 - 64 years with a physical disability who may be accommodated in the home is the named, male client referred to in the application dated 26 March 2004 The only service user in the age range 18-64 years with dementia who may be accommodated in the home is the named, male client referred to in the application dated 7th February 2006. 17th November 2005 2. Date of last inspection Brief Description of the Service: Ashbury Lodge is a private care home situated on the outskirts of Swindon. The owners also own another care home in the area. They operate the home as a family business. The home fulfils 3 distinct but complementary services. On the ground floor care and accommodation is provided to older people who need less supervision and have more awareness of their environment. On the first floor care and accommodation is provide to older people who need extra supervision. For reasons of safety the exit from this floor is electronically locked, and a lift has been installed. Each floor to all intents and purposes operates as a separate unit. The home provides for older people who either have dementia type conditions or experience (or have experienced) mental illness and older people who need care only because of infirmity or reasons associated with getting old. All but 4 rooms provide single accommodation, some with en-suite facilities. A copy of the service users’ guide is given to all new residents. Fees vary from £358.96 to £525 per week. Additional charges are made for chiropody, hairdressing, newspapers and toiletries. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in November, with a follow up visit in December. Ten service users and four members of staff were spoken to, as well as various family members, and the deputy manager and provider were present throughout the day. Various documents and files were examined, including care plans, health & safety procedures, risk assessments, and staff training files. Five residents, eight family members and one community nurse responded in writing to our questionnaires. A previous inspection was made in April to follow up a complaint which had been made to the Commission for Social Care Inspection (CSCI). At this time the providers were asked to ensure that radiators were covered and that risk assessments were put in place for those which had not been covered. This has been done, and the home now has several covered radiators as well as some with “cool-wall” surfaces. Risk assessments are in place, and weekly checks are made of the thermostatic controls. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: Residents are encouraged to maintain their independence, and supported in this by a dedicated staff group. People are encouraged to take responsibility for themselves, and to do as much as possible for themselves, subject to their abilities. One family remarked; “Ashbury Lodge is an excellent home and I cannot speak too highly of it”, and another said “We are very pleased with the care our mother receives”. Care records showed prompt referrals of health concerns to GPs, specialist nurses and other professionals. One resident had been supported through a terminal illness, and staff had been sensitive to the needs of the other residents as well as supportive to the family. The family of the resident involved said they were extremely grateful for the home’s support. They said “It was clear that our relative felt happy and secure at Asbury Lodge, and I know that you all contributed to this”. The home’s complaints procedures were seen to be operating well. Several concerns identified by families had been addressed appropriately by the deputy manager. All five residents who responded to our questionnaire said they knew Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 6 who to speak to if they were not happy and knew how to make a complaint. Five of the six relatives also knew about the complaints procedure. One resident spoken with said “I don’t have anything to complain about. Everything’s lovely”. 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. Ashbury Lodge Residential Home DS0000057248.V317781.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 Lodge Residential Home DS0000057248.V317781.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): 1, 2, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are informed about the services offered by the home, in order to help them decide if they want to move to the home. All residents admitted for long-term care had a contract in place. Everyone had an assessment of their needs prior to admission and the home was able to demonstrate that it could meet the needs of its residents. EVIDENCE: Ashbury Lodge has a statement of purpose and service users’ guide, which describe the services offered. This is given to either the resident or their family member when a referral is made to the home. Of the five people who responded to the questionnaire, four felt that they had had enough information on the home prior to admission and one said that they had moved there simply Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 9 to be near their family. All five stated that they had received a contract from the home. The records of two residents who had been recently admitted to the home were examined. A detailed range of information is obtained, including information on mobility, communication, specific health needs and family circumstances. Details of any medication support needed is written down and agreed with the service user or a relative. A member of the senior management team meets with any prospective service user and family as part of the assessment process. Following admission, the home then develops an initial care plan based on the assessment, in order to ensure the needs of service users are being safely met. Staff are issued with a procedure to help new residents settle in, and this includes giving them a cup of tea, helping them unpack, showing them round and sitting with them and talking over the first few days to help them get used to their new environment. One family member commented “I am very happy with the progress my father has made since arriving at Ashbury Lodge. It is a fantastic start by all concerned”. There were no intermediate care beds in Ashbury Lodge. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have all their health, personal and social care needs set out in care plans. Their health needs are fully met. Residents are protected by the home’s medication procedures, although there were some areas which could be improved. Residents feel they are treated with dignity and respect. EVIDENCE: Care plans were in place for all residents and showed evidence of regular review. Care staff were seen to use the care plans as working documents, seeking information from them and adding entries as necessary. Whilst talking to staff, it was clear that they were aware of individual’s needs, and daily records reflected this. Information on care plans related to sleep routines, eating, communication, mobility, personal care, emotional well being, a medical report, and socialisation likes and dislikes. One relative said “The staff are kind and considerate, and my parent is well looked after”. Of the five Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 11 residents who replied to our questionnaire, four people said they usually received the care and support they needed and one person said they always did. One resident thought that this would be helped by having more staff and another said “I appreciate they are busy at times and can’t always get to me immediately, but I never have to wait long”. All residents are registered with a General Practitioner (GP) and there is input from other health professionals, such as psychiatrists, dentists and opticians as required, with appointments being recorded in the care plan. Care plans also contain a section where GPs and district nurses can record their notes when visiting a resident. Weight checks are done for residents where there is any concern. The home notifies the Commission for Social Care Inspection (CSCI) of any incident where a resident is ill and needs to go to hospital, and these records show that emergency services are sent for quickly. One community nurse who visits the home said that if she gave any specialist advice, it was incorporated in the care plan, and that she was satisfied with the overall care provided to residents in the home. Medication is stored securely in the home, and staff do not administer medicines until they have received appropriate training. Information about various medicines is available in the home and all the medication administration records checked were clear and had been signed. However, it was noted that the oral medication for one resident was being given by using a syringe into the mouth instead of a spoon. This practice can be appropriate where a resident has swallowing difficulties, but it should be authorised by the medical practitioner. The home has been asked to ensure that this is done. It was also noted that whist most residents had their medication delivered from the pharmacy, some people had brought their medication from home. There was no stocktaking count of this medication and the home has been asked to ensure that they do so in future. The medication cupboard itself was dirty and sticky, and contained two air fresheners and a man’s razor. When questioned about this, staff were unable to provide a satisfactory reason. The home has therefore been asked to make sure that the medication cupboard is kept in a clean condition and that the other items which should be stored elsewhere are removed. All residents spoken with confirmed satisfaction with staff members and expressed that his or her privacy and dignity were respected at all times. Staff were observed knocking on doors and residents were spoken to with their preferred form of address. Residents confirmed that all personal care was given appropriately and staff respected their wishes when they wanted to spend time in their room. Staff induction training makes it clear that the home’s expectation is that residents will be treated with dignity, and that their independence and self esteem must be encouraged. All seven relatives who replied to our questionnaire said that they could visit their relative in private. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has developed regular activities provision that links with residents’ individual interests and capabilities. Residents are encouraged to follow their preferred routines and make their own choices. People can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. Residents receive a wholesome, appealing, balanced diet. EVIDENCE: All residents spoken to reported that they are able to follow their preferred routines and choose how they spend their day. Residents are therefore able to get up and go to bed at preferred times and spend time in their room as required. Some residents enjoy solitary interests such as reading, crosswords and television. Although the home employs an activities co-ordinator, she has been off sick for a while. There are various organised activities which people can join in with, and these include quoits, table skittles and reminiscence cards. One temporary resident who was admitted spoke only in Italian, and staff made a particular effort to obtain Italian phrases from the internet and Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 13 her family in order that they might communicate better with her. Of the five residents who replied to our questionnaire, four said there were always activities arranged by the home that they could take part in and one said “usually”. A register is kept of all the daily activities, and the names of all residents who choose to participate are recorded. Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Some family members keep in touch with regular phone calls. One resident said she goes out for meals regularly with her family and another talked about how often his son came to visit. Various comments received by family members included “Ashbury Lodge is an excellent home and I cannot speak too highly of it.” “Staff are always friendly and willing to help”. “The staff are kind and considerate, and my relative is well looked after” “My Nan is looked after very well, and I am pleased she is here. She is very happy here”. “We are very pleased with the care our mother receives”. Residents can bring some of their own possessions to the home when they move in, and many of the rooms contained personal items. It is the policy of the home not to become involved in residents’ finances. These are normally managed themselves or by their representative. Advocacy information is available at the home for those people who might need some independent support or advice. Improvements have been made to the preparation and quality of meals served. There are two cooked choices at the main meal and fresh fruit available at all times. There is a choice of meal at tea times including hot snacks. The cook is now ensuring all soft diets or pureed food is liquidised separately to ensure they are more presentable and palatable for service users. While most residents commented meals were “good”, one responded to our questionnaire that “meals are usually good. A few times I have not liked them, but an alternative has always been offered”. One resident reported that the plates were sometimes cold, and another that the food was sometimes not quite hot enough. Staff recently had training from the Alzheimer’s Society called Food for Thought, and this included giving them information about easy finger foods which people with dementia might find easy to hold and enjoy. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. The policies and procedures which the home has in place ensure that residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place, and this is given to service users and their families. There is a compliments and complaints file, and several compliments have been received from the families of people who have had care provided in Ashbury Lodge. Staff spoken to were clear that they wished the service to be run in the interests of the service users. The few complaints made by residents had been seen to be dealt with and residents and their families were satisfied with the outcome. All five residents who responded to our questionnaire said they knew who to speak to if they were not happy and knew how to make a complaint. Five of the six relatives also knew about the complaints procedure. One resident spoken with said “I don’t have anything to complain about. Everything’s lovely”. The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members are encouraged to report any incidences of poor practice, and a Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 15 “Whistle Blowing” procedure is also available. All long term staff have had training in Vulnerable Adults procedures, and there are plans for newer staff members to do so. There are guidelines in place for the management of challenging behaviour. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 16 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, 22 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well maintained and comfortable environment, which is clean and hygienic. They have the specialist equipment they require to maximise their independence. EVIDENCE: Ashbury Lodge is an attractive home, with large airy rooms and comfortable furnishings. A great deal of refurbishment has taken place, and the providers are to be congratulated on this upgrading. Walls have been opened and corridors have been widened, as well as ceilings being replaced. Furnishing and fittings were of a good standard, and many areas have been repainted and carpeted. The home employs a fulltime maintenance person, which ensures Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 17 minor repairs are dealt with quickly. A new lift has been installed for the benefit of those people who live on the upper floor of the home. Bedrooms were homely and each contained individual personal items. A cleaner is employed for each floor of the house, and a separate laundry worker is employed. Both the kitchen and laundry have their own cleaning routines. Several residents commented on the clean, fresh rooms. Three residents who responded to our questionnaire said the house was always fresh and clean and two said it “usually” was. A wide variety of specialist equipment was available for residents. Some were using rollators to help them move more easily around the home, and some were using walking frames. Wheelchairs were available for those who could no longer walk. The home uses sliding sheets to help people move in bed, hoists to help them move, and has handrails and built up toilet seats for those who need them. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has the number and skill mix of staff to meet residents’ care needs. A safe system for recruitment and selection of staff is in place. Residents are supported by staff who are trained in their roles. EVIDENCE: The home has employed three unit leaders to ensure there is a senior member of staff on duty at all times. The rota showed there are a minimum of two care staff on each unit and four waking night staff. In addition the home employs an activities coordinator, laundry person, maintenance person and two domestics, which would indicate care staff are not taken away from the task of caring for service users. Of the seven relatives who responded to our questionnaire, six said they felt there were enough staff on duty and one felt there was not. This person felt that this may be because staff were in other areas attending to residents. One resident replied that staff were “always” available when you need them, three said “usually” and one said “sometimes”. This person felt that this was more during the night, but said that it was better during the day. There were sufficient staff on duty to meet the residents’ needs on the day of the inspection. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 19 One community nurse, who responded to our questionnaire said she gets upset when the foreign staff members speak to each other in their own language. She worries for the elderly people in the home who can be hard of hearing. She also said she has to speak very clearly in order to be understood. However, all staff on duty during the inspection were able to be understood and to understand any conversation. They were also seen to be communicating well with residents. Ashbury Lodge’s employment checks include Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, two written references and a medical declaration. All potential staff complete an application form, and this is kept by the home. All staff files examined were seen to contain all this information. Any staff who had been subject to disciplinary measures had this clearly recorded in their file. All new staff receive induction training, and a structured training plan is in place for the others. Some staff have a nursing qualification, although they are not currently employed as nurses. Three staff have done their NVQ Level 2 and three more are currently doing it. Two staff are doing their NVQ Level 3 and one is doing NVQ Level 4. One domestic staff member is doing an NVQ in housekeeping. Other training has included safe handling of medication, protection of vulnerable adults, manual handling, infection control, health and safety and dementia training. Staff recently had training from the Alzheimer’s Society called Food for Thought, and this included giving them information about easy finger foods which people with dementia might find easy to hold and enjoy. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home which is run and managed by a person who is fit to be in charge, and which is run in their best interests. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. EVIDENCE: The manager, Ms Geraldine Smith, has been in partnership running care homes for older people for many years. The deputy manager, Ms Polly Williams is now preparing to take over the management of Ashbury Lodge. She has achieved her NVQ Levels 2 and 3, and has now started to complete her Registered Manager’s Award. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 21 A quality assurance survey undertaken with residents and their families had resulted in eighteen responses from the forty-four sent out. This had shown high rates of satisfaction, with the main areas highlighted being the redecoration, the helpfulness of staff. There was some feeling that activities for residents could be further developed. The providers had fed back the findings and resulting intentions from the survey to residents and visitors, by way of a newsletter. The deputy manager visits all areas of the home and speaks to residents every day, which helps to foster good relationships. The company has recently achieved the Investors in People Award. Although no bank accounts are held for residents, the home manages the personal allowances for most of them. This means that the home starts with a balance sheet of money from the family and deducts any personal expenditure. The home’s administrator usually takes responsibility for all financial transactions, and clear records and receipts are kept. All money in and out of the balance sheets was able to be accounted for. There were good health & safety records in place. Records show that staff have been trained in areas relating to health and safety, such as fire safety, manual handling and prevention of spread of infection. The home’s fire extinguishers and other equipment are serviced on a contractual basis. At a previous inspection, it had been noted that several radiators were extremely hot, and the home had been asked to ensure that all radiators had guards fitted or have low surface temperatures. At the second visit to the home it was noted that this had been done for most radiators and that those which had not been covered had a risk assessment in place. This risk assessment also ensured that the temperatures of the radiators were checked on a weekly basis. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 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 OP9 Regulation 13 (2) Requirement Any medication coming into the home from residents’ homes must be counted and recorded. The medication cupboard should be kept in a clean condition, and used for the storage of medication only. Timescale for action 02/11/06 2. OP9 13 (2) 02/11/06 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 OP9 Good Practice Recommendations 1. Any staff trained in taking residents’ pulse measurements should have their competence recorded. Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Ashbury Lodge Residential Home DS0000057248.V317781.R01.S.doc Version 5.2 Page 25 - 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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