Inspection on 07/11/05 for Ashby Court Nursing Home

This inspection was carried out on 7th November 2005.

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 24/05/07

Ashby Court Nursing Home 08/06/06

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 Wendy Taylor Unannounced Inspection 7th November 2005 08:50 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.V265404.R01.S.doc Version 5.0 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.V265404.R01.S.doc Version 5.0 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.V265404.R01.S.doc Version 5.0 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 accomodated is 42. 2. Date of last inspection Brief Description of the Service: Ashby Court is registered to provide nursing care and personal care to persons over the age of 65years. The property is purpose built and was originally designed for warden controlled accommodation. It is situated in a residential area close to Hartsholme Park, local facilities of shops and post office are approximately 270 metres away. The city centre of Lincoln is approximately 34 miles away. There is also a day centre attached to the home and service users are able to access the facilities if they choose, these include, a library, shop and hairdressing salon. 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. Accommodation is provided in mainly single flats, which comprise of a sitting room, bedroom, kitchenette, shower and toilet. Two double flats are also available. Accommodation is available on two floors, first floor rooms are accessed via a shaft lift. There are also two communal lounges and a dining room. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 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 2005. It is the second unannounced inspection of the home this year. There were no requirements made at the previous inspection and actions have been taken in regard to all of the recommendations. Resident and staff files were looked at, and a number of residents, staff and a relative were spoken to. A tour of the building took place and general observations of interactions and care practices were made throughout the visit. Residents described staff as ‘lovely’, they said that they were treated very well and that staff they will help with anything they want. The atmosphere in the home was relaxed and pleasant. What the service does well: What has improved since the last inspection? What they could do better: Although the home provides a range of more formal activities, it has been recommended that they review the arrangements in place for general daily activity. The home should ensure that records of personal identification numbers for qualified nurses are kept up to date, and it is recommended that they record end of life wishes/arrangements on all care files where the resident and/or their relatives are willing to discuss the issue. It is also recommended that the home review that storage of toiletries in communal bathrooms. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 6 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. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 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.V265404.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5, 6 Resident’s benefit from pre-admission assessment and support which assures them that the home can meet their needs. EVIDENCE: The home does not provide intermediate care. There are pre-admission assessments on resident’s file, which contain details of leisure and religious needs. There was evidence that the assessments have been carried out with the resident, their relatives and involved professionals where appropriate. There was evidence that residents and/or their families have received terms and conditions and contracts for the placement. Residents and relatives spoken to said that they had the opportunity to look around the home prior to admission. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10, 11 Care plans are clear and consistent and residents are protected by risk assessments, however the home does not provide assurance to all residents that end of life arrangements will meet their wishes. EVIDENCE: Four resident’s files were looked at. Care plans contained clear direction in regard to needs such as pressure area care, dementia, pain management and sleep. Risk assessments were related to needs such as moving and handling, falls, use of kettles and locking doors. Each file contained care plan agreements signed by the resident or their relatives and there was evidence of monthly care plan reviews, again the review sheets were signed by the resident or their relative. Where applicable, files also contained annual review reports by the placing authorities. Some files contained information on end of life wishes/arrangements and others did not. A recommendation has been made that this is recorded for all residents where they and/or their relatives are willing to discuss the issue. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 10 There is evidence that staff receive training in palliative care and managing end of life arrangements in a respectful and supportive manner. Residents said that staff talk to them respectfully and said that they always uphold their privacy. Staff were observed throughout the inspection to maintain privacy when carrying out personal care or when discussing things with residents. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 Residents’ are supported to maintain choice and control in their lives, to whatever level they are able. Although the home provides a good range of entertainment and outings, the resident’s would benefit from a programme of daily activity in a setting of their choice. EVIDENCE: There was evidence in records that a range of activities and entertainment are provided for residents such as fireworks evenings, general outings and inhouse entertainers. The home also maintains records of when residents’ have been offered activities but they have declined to engage in them. There are library facilities available and residents have access to talking books and newspapers. There is a large entertainment room available for functions, within the day service side of the building. Communion timetables and residents meeting dates are made available on notice boards in the main ground floor corridor. Residents and a relative said that the home provides a good range of more formal activities, but could provide more support for general daily activity. Residents said that they do not always want to go to the day centre and would like to stay in their home to do activity. Staff said that although there is enough staff to meet care needs, there is not always time to spend sitting and chatting with residents or organising daily activity. The manager Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 12 said that the home will be recruiting in the near future and this should make more staff available on some shifts. A recommendation was made. Menus demonstrate choice for residents and the kitchen staff are aware of individual likes, dislikes and needs. There is evidence of regular monthly residents meetings and care plans demonstrate that resident’s are involved in their development (see Standards 7-11). Residents said that they are encouraged to retain choice and control regarding all aspects of their lives for example diets, activity, rising and retiring times and how carers provide their support. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents and relatives benefit from the homes’ responses and co-operation with investigation processes, and they are assured that they will be listened to. EVIDENCE: Since the last inspection there has been one anonymous complaint about the home, which was managed appropriately and within the home’s complaints procedures. There is evidence of staff training in adult protection procedures and staff demonstrated their awareness and understanding of the issues. Resident’s and a relative said that whenever they have raised issues with the home, they have had a satisfactory response. Residents and relatives said that they are able to air their views at regular monthly meetings. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 26 The home provides comfortable surroundings and pays attention to improving the décor of the building. Resident’s benefit from personal rooms that allow them to maintain as much independence as possible. EVIDENCE: There were new carpets being fitted around the home during the inspection. There was also evidence of recent redecoration in corridors. Residents said that they liked the carpets and they made a positive difference to the look of the home. The manager said that new pictures for corridors and bedroom door signage has been decided upon and will be in place in the near future. Each room has en-suit toilet and shower facilities and there is also access to three baths on the ground floor. The home provides an assisted ‘Parker’ bath, an over bath hoist, grab rails, raised toilet seats, shower seats and mobile hoists. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 15 On the day of inspection there were six housekeeping staff on duty. The home was very clean and tidy and housekeeping staff were interacting very well with residents. All rooms were personalised with the resident’s own furniture and other personal possessions. There was an individual inventory of furniture in resident’s files. Each room has it’s own kitchen area, lounge area and it’s own doorbell. Resident’s said that they liked their rooms and found them comfortable and spacious. A resident and a relative said that they chose this home because of the bedroom facilities. There is a well-maintained courtyard garden, which residents said they used extensively in the summer. There is a spacious and nicely laid out dinning room and a smaller dinning area for people who require more privacy when taking their meals. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30 There is an appropriately trained staff team who are able to meet the needs of the residents. However in order to fully protect residents the home should ensure records are complete and up to date. EVIDENCE: Staff said that they have access to good induction training, which includes fire safety, policies and procedures, adult protection, introduction to residents and confidentiality. They said that there is also access to training in such areas as pressure area care and NVQ Levels 2 and 3. The home has a training plan in place for 2005/2006, which includes mandatory and specialist training courses. A named member of staff (qualified nurse) provides regular in-house training sessions. There was evidence of regular staff meetings. For staff recruited by Lace Housing, all information required in Schedule 2 was available in files. One staff file did not contain references, however a previous provider recruited this person more than ten years ago. The manager said that the previous provider managed storage of information differently and references may have been held elsewhere. The record of personal identification numbers for qualified nurses was not up to date. (See Standards 12-15 for information on staffing levels). Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 38 Resident’s benefit from an open and supportive management approach and a well supported staff team. The home continues to ensure that records are generally well maintained, however they should be aware of any potential risks to resident’s safety and manage them effectively. EVIDENCE: Residents and a relative said that the registered manager is very approachable and will help to resolve any issues that may arise. Residents said that they see her regularly around the home and she will always make time to stop and chat. Staff also said that the manager was approachable and very supportive. They said that they are generally well supported in their work and have regular supervision meetings, which they find useful. Records confirmed that staff receive regular supervision. A recommendation was made in relation to supervision records. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 18 Environmental risk assessments were in place for issues such as fire, call systems, the resident cat, decorating and carpet renewal. The home has a new call system, which records call times and response times. There was evidence of regular monitoring of the response times. Fire safety and training records were satisfactory, as were water temperature and general maintenance records. During a tour of the building it was noted that toiletries were stored openly on a bathroom shelf. A discussion took place with the manager regarding safety issues and a recommendation was made. Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 19 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 4 X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 20 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 OP30 Regulation 18(3), 19(5)(b) Requirement Records must demonstrate that all qualified nurses hold a current registration with the Nursing and Midwifery Council. Timescale for action 21/11/05 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 2 Refer to Standard OP11 OP12 Good Practice Recommendations It is recommended that end of life wishes/arrangements are recorded on all care files where the resident and/or their relatives are willing to discuss the issue. It is recommended that the home review the level of staff support that is available for organising and providing activities and consider the development of an activity coordinator post. It is recommended that the manager reviews files for those staff that were recruited by the previous provider. It is recommended that the home consider the use of a front sheet for supervision records, which demonstrates that sessions have taken place. It is recommended that toiletries are stored in a safe and secure manner within communal bathrooms. 3 4 5 OP29 OP36 OP38 Ashby Court Nursing Home DS0000002529.V265404.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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