Inspection on 24/05/07 for Ashby Court Nursing Home

This inspection was carried out on 24th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashby Court Nursing Home 08/06/06

Ashby Court Nursing Home 07/11/05

Ashby Court Nursing Home 19/05/05

Ashby Court Nursing Home 08/12/04

Ashby Court Nursing Home 19/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ashby Court Nursing Home Ashby Avenue Hartsholme Lincoln Lincs LN6 0ED Lead Inspector Vanessa Gent Unannounced Inspection 24th May 2007 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 Ashby Court Nursing Home DS0000002529.V338123.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. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashby Court Nursing Home Address Ashby Avenue Hartsholme Lincoln Lincs LN6 0ED 01522 695458 01522 696252 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) enquiries@lacehousing.org LACE Housing Limited Mrs Cathy Trevor Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following category:Old Age, not falling within any other category (OP) (42) The maximum number of service users to be accommodated is 42. To be able to admit the named person of category PD (under 65 years) named in variation application number V35766 dated 12 October 2006. 8th June 2006 2. 3. Date of last inspection Brief Description of the Service: Ashby Court is registered to provide personal and nursing care to up to 42 people of both sexes over the age of 65 years. The two-storey property is purpose built. It was originally designed as warden-controlled accommodation. The home is owned by L.A.C.E. housing association which is a non-profit making organisation providing housing and care services for older people. It is situated in a residential area close to Hartsholme Country Park. There are small local shops and a post office within 300 yards. It is on a bus route into the city of Lincoln, about 3 miles away. A day centre is attached to the home where residents can use the facilities as they choose. These include an activities room with stage and dance floor, library, shop, coffee shop, extra bathing facilities and a hairdressing salon. Each accommodation is a separate flat, with a bedroom-cum-sitting room, kitchenette and shower with toilet. Each flat has ample storage space. The flats look out onto attractive gardens or parkland across the road from the home. There are 37 single and three double flats. One of the doubles is currently used as single accommodation. Accommodation is available on two floors with access to upstairs via a passenger lift, for people with limited mobility. Communally, there are two lounges, a dining room with an extension, two bathrooms, and toilets situated near the lounges and dining room. These are in addition to the facilities provided by the day centre. The manager keeps printed copies of the statement of purpose, service users guide and latest inspection report at the home readily available for people using or enquiring about the service. The current range of fees for the home is £375 to £562. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 12.15 and lasted 7 hours. Information already held on file was used to plan the visit. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of residents, and examining the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. The site visit focused on whether key standards and requirements from previous inspections had been met and how the residents feel about the service provided. Three residents’ assessments and care plans were examined. This is to ensure the health, safety and welfare of the residents is checked and that residents are allowed dignity, autonomy and choice. A partial tour of the home was made and a sample of other records examined. Six of the staff on duty and eleven of the forty-one residents, including those being case-tracked, spoke with the inspector. The manager was available for the last part of this inspection. What the service does well: What has improved since the last inspection? No requirements were set at the previous inspection. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 6 Within the past twelve months, an ongoing programme of re-decoration has taken pkace, with some furniture and curtain replacement. The laundry has been fitted with two new washing machines with full sluicing facilities and a new tumble dryer. There is a new fire alarm system and A-call system in place to improve the safety of the home for all. 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. Ashby Court Nursing Home DS0000002529.V338123.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 Ashby Court Nursing Home DS0000002529.V338123.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, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have enough knowledge of the home before they decide if they want to stay. The home gains enough information to determine that it can meet the needs of prospective residents before they are accepted. EVIDENCE: An up-to-date copy of the statement of purpose and service users guide are kept next to the visitor’s signing in book in the foyer. The manager says each resident is given a copy. Residents said they are aware of them and can look at them any time they want. One resident said her daughter chose the home for her; another said they were offered a place whilst the accommodation was still a warden-aided Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 9 complex and has lived there for many years. A third resident said he came on a month’s trial and has willingly stayed ever since. All three say they are very happy with their flats, surroundings and facilities. They agreed, “It is second to none.” Care plans contain pre-admission assessments. Where these are done by the manager or other staff, they are minimal and basic but adequate for the home to determine if it can meet the needs of a prospective resident. Ashby Court Nursing Home DS0000002529.V338123.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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a lack of detail and organisation in the care plans. This means the care staff may not always know what the residents’ care needs are, which may leave the residents at risk of harm or neglect. Staff liaise with healthcare professionals, have safe medication practices to ensure the residents are cared for safely and respect the wishes and choices of residents at all times. EVIDENCE: At the visit to the home, care plans are not always comprehensively completed. Some information of incidents that have occurred is missing. These are sometimes recorded in one area but not in other records as required, such as the accident book and notifications to the commission. Daily records are not always in sequence, with new pages being started, then staff returning to previous pages to continue the records. This does not make for easy or Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 11 accurate reading. It may leave the resident at risk of harm or neglect. However, immediately following the inspection visit, the manager has put in place measures to correct this situation, examples of which were submitted to us, which now protects residents from the risk of neglect or harm. Although traditionally the nurses have been the only staff to fill in the care plans and daily records, care staff are now being trained to complete care plans for residential residents as they are often most closely involved with them. The care plans in place for all residents show the involvement of residents or their representatives. They have signed them to show they agree with the initial plans or the reviews. Residents say they know about the care plans and can see them at any time. During the inspection visit, the community specialist tissue viability nurse attended a resident in response to being called by the resident’s named nurse. There is evidence that the manager and nursing staff liaise with specialist healthcare professionals as and when necessary. The nurse in charge of the shift was observed during the lunchtime medication round. Their practice and records kept are satisfactory, to safeguard the residents. Six staff are booked to start studying for a ‘Safe handling of medicines’ certificate from 1st June. Residents feel they are treated with respect and dignity. They say, “staff are lovely”. During the inspection visit, staff spoke with and handled residents in a calm, friendly manner and residents responded positively. Ashby Court Nursing Home DS0000002529.V338123.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 good. This judgement has been made using available evidence including a visit to this service. Residents have choice in and are satisfied with all aspects of their lives although some would like more choice of out-of-home activities, which are limited through a lack of funds. EVIDENCE: Daily activities are readily available, both in the Day Centre as well as some in the home itself. Residents all say there are plenty of activities to choose from but most of them are happy to “potter between our own flats and the common room or lounge. Most of us come down for lunch and dinner.” There is a shop, library and hairdressing salon, with no restrictions on where they can go. Several go out into the local community on their own. Residents’ mobility scooters are stored around the home where there are ‘hook-ups’ for charging the batteries. Some trips are organised, although these are not as much or as often as some residents say they would like. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 13 Many of the residents have visitors and they have space in their rooms to entertain them in privacy. Residents say that staff respect their privacy and independence and are understanding and helpful when they have visitors. The manager says that all the in-house entertainments, outings, trips and the ‘translinc’ transport used have to come from the ‘Residents’ comfort fund’; none are provided by the owners of the home. All say they have choice in every aspect of their lives at the home. Some have lived there for many years and have found friends among other residents. They say staff are friendly and caring. Residents say the food is “reasonable but not brilliant”, “the quality of meals is variable”; “the quantity’s enough”. They say some meals are very good. The cook says they are just trying the new summer menu and it sometimes takes a while to get things just right for everyone. Carers ask residents what their choice of meals are for the following day. Residents are happy with this arrangement. Ashby Court Nursing Home DS0000002529.V338123.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are investigated thoroughly but not always responded to in a timescale that may be acceptable to the complainant. Residents feel they are listened to and responded to if they have any concerns. Residents are comfortable and feel safe in the home. All staff have received training to protect the residents from harm or abuse, to ensure that residents may be kept safe at all times. EVIDENCE: The complaints policy and procedure is clearly defined in the statement of purpose and residents say they know how to complain if they are not satisfied. Residents say they are happy with the care provided, feel safe and have no complaints at all. The one complaint anonymously received from a visitor in 2006 was investigated adequately by the provider but not responded to within an acceptable period of time. Residents say they feel safe and that the “carers are all lovely” and “the care is second to none”. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 15 Staff say they feel confident to care safely and appropriately for the residents at all times. All staff receive training for safeguarding adults in their induction. Further training for safeguarding adults was undertaken by most staff in December 2006 to bring all staff up-to-date in being able to care safely for the residents. Ashby Court Nursing Home DS0000002529.V338123.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, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, clean, safe environment in which the residents are well cared for and ‘at home’. EVIDENCE: Residents say they love their flats and the independence it gives them and having their own front doors which gives them more privacy. Each flat consists of a bedroom-cum-sitting room, a kitchenette and a shower room. All have a pleasant outlook over the gardens. One resident says, “it’s our own home only a smaller flat”. They say the home is “always good, clean and tidy”. The garden provides an attractive, tranquil outdoor area for residents to sit in. There are a restricted number of car parking facilities. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 17 The maintenance man and manager both say there is a yearly decoration plan with is dealt with by the property maintenance manager. Residents are encouraged to personalise their rooms with their own furniture and ornaments. This was confirmed in the rooms the inspector visited. The laundry has had two new washing machines and a new tumble dryer which, staff say, are “super efficient”. A new fire safety system has been installed as has a new A-call system for responding to residents’ needs more effectively. Ashby Court Nursing Home DS0000002529.V338123.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by robust recruitment procedures, induction and training, which support staff to provide a good quality of care. EVIDENCE: The staff duty rota indicates that there are enough staff on duty at all times to basically meet the current needs of the residents. Residents say call bells are usually answered without delay. None were left unanswered for long during the inspection visit. Residents feel there are enough staff on duty to attend to their needs whilst in the home but they would like enough staff to be available when they want to go out. Staff say they are more rushed in the morning and do not have enough time to sit with residents and chat, although they have more time for this in the afternoons. Staff feel they fulfil their duty of care but the care plans indicate that some staff do not have enough time to adequately complete them to ensure residents are cared for safely at all times. The manager says some residents only need minimal help with washing-up and bed-making. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 19 Staff say they are supported in their training, including taking national vocational qualifications (NVQs). Twelve staff have achieved either level two or three with one currently taking theirs. The recruitment and induction training of new staff meets the requirements set by law. Staff say they feel that their induction enables them to provide a safe and satisfactory service to the residents. Induction can last up to eight weeks or however long it takes for them to feel confident in their caring roles. Staff say they enjoy coming to work and “we all work as a good team together”. Courses undertaken in the past year include fire awareness, moving and handling, infection control, prevention of abuse in vulnerable adults and food hygiene. Ancillary staff have received training in ‘control of substances hazardous to health’. The training programme for the coming months will cover first aid in July 2007, ‘principles and practices of mentoring’ for two staff, ‘safe handling of medicines’ for six staff, ‘palliative care’ for two staff and tissue viability. Staff say the training programme is good and supports their safe practice of care. Ashby Court Nursing Home DS0000002529.V338123.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, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a manager who is well thought of and who ensures that the residents’ well-being, safety and finances are safe-guarded. Some quality assurance is in place but does not cover all aspects of monitoring the views, opinions and wishes of residents, relatives or staff. The excellent maintenance of the home ensures that residents are safe in the home at all times. EVIDENCE: The manager is a trained nurse and has achieved her Registered Managers Award. Residents and staff speak highly of the manager. They say she is Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 21 “supportive”, “available”, “always there for you and very caring”, “thoughtful” and “leads well”. In the past year, the provider has not visited the home on a regular basis to undertake the monthly review of the service and report on it, as required. The manager has given residents a satisfaction survey to complete and gathered the information to help to improve the service provided. Regular resident meetings are held, as are regular staff meetings. All are given chance to have their say and thereby influence the quality of the service available and provided. The manager says she also monitors the care plans monthly to ensure they are completed satisfactorily. The manager says she will keep more formal records of this for future reference. Most residents take care of their own finances or have relatives to do this for them. Measures are in place to show that where the home assists residents by minding their personal allowances, this is done appropriately and safely. The manager says all staff are supervised regularly at least every other month. Staff confirm they have regular supervisions and feel supported by them. The maintenance programme in the home is excellently undertaken and recorded. The maintenance man says staff are very observant and report repair needs to home without delay. These needs are looked at and attended to daily, as confirmed in the maintenance record book. The Environmental Health Officer has visited the home within the past two weeks and reported that the home has no health, hygiene or safety issues to deal with. Ashby Court Nursing Home DS0000002529.V338123.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 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 3 2 X 3 3 X 3 Ashby Court Nursing Home DS0000002529.V338123.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 OP7 Regulation 15 Requirement Care plans must at all times clearly describe any changes in the residents’ conditions and the appropriate care that staff should provide, to ensure the care the residents receive is what they need and want. The provider must undertake a monthly audit to report on how the home meets the needs and wishes of the residents. A copy must be made available to the manager. Timescale for action 30/06/07 2. OP33 26 31/07/07 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 OP33 Good Practice Recommendations It is good practice for the provider to send a copy of the monthly audit report to the commission. Ashby Court Nursing Home DS0000002529.V338123.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Ashby Court Nursing Home DS0000002529.V338123.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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