Inspection on 08/06/06 for Ashby Court Nursing Home

This inspection was carried out on 8th June 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

Ashby Court Nursing Home 24/05/07

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 Wendy Taylor Key Unannounced Inspection 8th June 2006 08:30 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.V286631.R01.S.doc Version 5.1 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.V286631.R01.S.doc Version 5.1 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.V286631.R01.S.doc Version 5.1 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. 2. Date of last inspection 7th November 2005 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. The current range of fees for the home is £ 360:00 to £541:00 Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place during June 2006. It involved a review of all the information currently held by the Commission for Social Care Inspection (CSCI); a review of questionnaires completed by residents and a visit to the home. The visit to the home included discussions with residents, staff and the registered manager, a tour, observations of care practice and looking at records kept by the home. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations made during this key inspection. All of the National Minimum Standards inspected were met and in some cases exceeded. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 6 An area that the registered manager may wish to develop further is the level of detail contained in the care plan reviews, although it is recognised that the standard relating to this area is met. 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.V286631.R01.S.doc Version 5.1 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.V286631.R01.S.doc Version 5.1 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): 1,3,4,6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home provides a clear and robust pre admission assessment process and assures people that they can meet their needs. EVIDENCE: Three residents care files were looked at during the visit to the home and all contained pre-admission assessments that demonstrated the involvement of the resident, relevant professional and relatives where appropriate. There was also a letter on each file to say that the home can meet the assessed needs. Feedback from residents indicated that they had received enough information about the home prior to admission. A copy of the home’s statement of purpose and service user guide were available in entrance hall and there were signatures on individual files to say that the resident and/or their representative have received the above. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 9 The home does not provide intermediate care services. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home provides clear care plans that addresses the assessed needs of the residents, and which are reviewed and updated regularly. Review records could be further improved by increasing the level of detail contained within them. EVIDENCE: Daily records were available for each resident and were written clearly; they also cross reference with, for example GP and/or District Nurse visits. Each resident has an individual care plan and the needs covered include continence, moving and handling, anxiety and tissue viability. Residents said that they have seen the plans and they talk to staff about them and they or their representative sign the plans. Records demonstrate that care plans and assessements for needs such as tissue viability are reviewed monthly. Some review records did not contain a Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 11 great deal of detail and the manager said that she would address this issue with staff. There was evidence that the manager carries out a monthly check of care plan reviews to ensure that they are up to date. Choice and privacy are explicit in the care plans and one resident said that their mobility has improved since coming to the home; they feel that this is down to staff following the care plan and knowing what theyre doing. Medication records were satisfactory and observation of administration procedures demonstrated good practice guidance and policies and procedures are followed. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. The home provides a good range of activities within and outside of the home. Residents are afforded choice and control in all aspects of their lives, and have an opportunity to influence the development of the service. EVIDENCE: The home has begun to implement a new nutritional assessment tool and there is evidence in records that the dietician is being consulted where appropriate. The assessment includes weight recording. Staff said that they speak to residents and/or their representatives and explain the outcome of the assessment and offer advice as to how to improve their nutritional intake. There were differing opinions about quality of food at the home. The most recent survey for residents showed that 5 were not satisfied with the quality. Comments such as ‘don’t like so many healthy options’, ‘vegetables are not cut up small enough’, and ‘the meat is sometimes too tough’ were made to the inspector during the visit. Two residents said that they can discuss their views about the food at resident’s meetings and there is a comment book in the dinning room. The manager said she would continue to monitor residents’ comments. Meals on the day were well presented; there were ample portions, Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 13 and all of the residents spoken to say they enjoyed the food available at the meal. Staff were observed to be offering choices prior to and during meal; the meat appeared to be very tender and the vegetables were all eaten. A range of activity is available such as a knitting club, baking club and fitness club. These activities were agreed though residents meetings. Residents said that there are quite a lot of activities on offer, however some said that they choose not to join in and staff acknowledge this choice. Outings and in-house entertainment details are displayed on a notice board and residents are given individual reply forms to say whether they would like to participate. Visits from the local churches are also listed on the notice board. The home continues to provide library facilities, talking books and newspapers. Residents said that they receive visitors when they wish and they have private space to meet with them. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home promotes the rights of the residents and ensures that they are able to express their concerns and opinions within a supportive and responsive atmosphere. EVIDENCE: There have been no complaints or adult protection reports since the last inspection. A copy of the home’s complaints policy was available in the statement of purpose and the service user guide. Residents said that they know who to talk to if they are not happy and feel safe living at the home. They said that they are encouraged to voice their views at residents meetings and the minutes confirm this. Some residents said that they do not go to the residents meetings through choice, but they can still voice their opinions. Residents also said that staff listen to what they have to say and try to help them get what they need. Staff demonstrated a good working knowledge of adult protection issues and what to do if people make a complaint. Staff said that they receive training in adult protection issues and training records confirmed this. Residents said they get an opportunity to vote in local and general elections by either the postal option or going to the polling station. There was information Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 15 displayed in the home as to how to contact the local MP, and also there was information displayed about welfare rights. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,23,24,26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home continues to provide a high standard of personal accommodation and maintains good standards in regard to the provision of equipment, general maintenance and hygiene. EVIDENCE: On the day of the visit the home was found to be clean and tidy with no mal odours. Individualised risk assessments were available on resident’s files for issues such as locked doors. Signs to indicate the presence of oxygen where displayed where appropriate. There are a range of baths and hoist to meet the assessed needs of the residents. There is a spacious dinning room, and the tables were laid nicely for the lunchtime meal. The manager said that they have a lockable cupboard available to store toiletries in the downstairs bathroom and it is to be fitted in the near future. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 17 The cook described a new recording system for health and safety monitoring that is to be implemented next week. This was developed as a result of advice taken from the Environmental Health Officer at a recent visit to the home. The garden area was well maintained and accessible, and a range of garden furniture was available. The home maintains the same high standard of personal accommodation as was seen at the previous visit, with rooms having en-suite toilet and shower facilities, a kitchenette and a lounge area. There are individual inventories of personal furniture in resident’s files and there is evidence of an annual maintenance and property audit. There was differing opinion from residents as to the efficiency of staff answering call bells. Some residents said that call bells were not always answered promptly, some said they were. The average response time logged on the electronic response record on the day of the visit was 3-4 minutes. A recent audit of the response times carried out by the manager showed an average of 2.5 minutes. The protocol sets out a response time of 5 minutes. The manager said that she also reviews response times on a daily basis. One bell tested by the inspector did not work consistently and the manager made arrangements immediately to have it fixed. She also said that a risk assessment would be put in place for the time until the bell was fixed and all other bells would be checked. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Residents are protected by robust recruitment procedures. There is also a robust training package in place that enables staff to meet resident’s individual needs. EVIDENCE: On the day of the visit to the home there were 5 carers, 1 qualified nurse, domestic staff, kitchen staff, the registered manager, the administrator and one student nurse on duty during the morning shift. Staff said that there is generally enough staff to meet resident’s needs but they would benefit from more staff in the morning when the home is full. They said that this would allow them more time to sit and chat with residents. Since the last visit to the home there has been an increase of 42 staff hours but the manager said that she would continue to monitor staffing levels. Feedback from residents indicated that staff were available when needed. Staff said that they like working in the home and there is good teamwork. They said that there is good support from manager and she will respond to any concerns that they may have. There is evidence of a staff meeting every two months. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 19 Staff personnel files contained the information required by Schedule 2 of the Care Homes Regulations, 2001 including up to date Nursing and Midwifery Council registration details for qualified nurses. Staff said there is a good induction and training package and induction checklists were seen. Records show that staff also receive training in tissue viability, welfare and benefits, palliative care, infection control, catheter/continence care, first aid and medication administration. Training in dementia needs and sensory impairment is within the training plan. A training co-ordinator has been in post since February 2006. Residents said that staff are very polite, they look after their privacy and dignity and they get on well with them. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home has robust quality assurance processes that encourage residents to be involved in the development of the service provision; and they take action to reduce potential risks to health, safety and welfare needs of residents. EVIDENCE: The report of a recent quality assurance survey for residents that was carried out in January 2006, indicated that residents were generally satisfied with the service they receive. Residents and staff said that the registered manager was approachable and helpful (also see Standards 27-30), and there is a comment book available in Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 21 the entrance hall for residents and visitors to use. An equal opportunities questionnaire is included in the resident referral pack Financial care plans are available in resident’s files where applicable and there is also a list of personal property recorded. There was evidence that senior managers from the company that own the home visit annually and talk directly with residents about their experiences of living there. They then produce an action plan to address the issues, if any, raised by the residents. During a tour of the building a spray bottle containing disinfectant was stored openly on the windowsill in the ground floor bathroom. The manager ensured that it was removed and locked away immediately and a risk assessment was completed. The manager also said that she would reiterate safe storage issues with staff. There was evidence that servicing was up to date for baths, hoists and fire safety equipment; and risk assessments were available for the Control Of Substances Hazardous to Health (COSHH) and general environmental issues as well as COSHH safety data sheets. Staff said that they have regular individual supervision sessions and records confirm this. There is now a front sheet on those records to demonstrate that sessions have taken place. Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 3 3 4 X 3 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashby Court Nursing Home DS0000002529.V286631.R01.S.doc Version 5.1 Page 24 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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