Inspection on 05/12/08 for Ashby House

This inspection was carried out on 5th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashby House 25/07/07

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Ashby House 100 Chadwick Drive Milton Keynes Bucks MK6 5LS The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Chris Schwarz Date: 0 5 1 2 2 0 0 8 Information about the care home Name of care home: Address: Ashby House 100 Chadwick Drive Milton Keynes Bucks MK6 5LS 01908696676 01908609809 ashby@barchester.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) vacant post Mrs Keren Welch Type of registration: Number of places registered: Barchester Healthcare Homes Ltd care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 64 0 Over 65 0 64 Conditions of registration: The registered person may provide the following category of service only: Care home with nursing - (N) tos ervice users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age- not falling within any other category (OP) The maximum number of service users to be accommodated is 64. Date of last inspection Brief description of the care home Ashby House is owned by Barchester Healthcare Homes Limited and provides care and accommodation for 64 older people. The home is on one level divided into two Care Homes for Older People Page 2 of 9 separate living units, Bradwell and Oakgrove. Each unit has its own lounge and dining room, and all bedrooms have en-suite facilities. Bradwell provides care for frail older and physically disabled people, and Oakgrove provides care for older people who have a varied degree of dementia related conditions. The home is situated in a residential area of Milton Keynes close to local amenities, and public transport is accessible from the home. Care Homes for Older People Page 3 of 9 What we found: Care plans were in place for each person using the service. A selection of files of people with dementia were read. These were well maintained, up to date and followed a corporate format. Files were well organised and information easy to locate. The office where the files were located was locked when not in use. Each file contained a photograph of the person and information about their preferred name, ethnicity, marital status, date of birth, date of admission, reason for admission, where they had previously lived, their previous occupation, next of kin and other contacts. Information had been obtained on past and current medical history, observations and allergies were noted and their medication on admission was recorded. Information about peoples religious or cultural needs was noted and files contained details of arrangements for dealing with mail and ability to manage money. Current and previous doctor details were noted. Files contained peoples admission assessments, which had been dated and signed. These provided information about a wide range of care needs such as peoples communication needs, personal hygiene, mobility and dexterity, moving and handling, tissue viability, nutrition, breathing, pain, sleeping, elimination and continence, mental state, social interests and hobbies, family, carer and friends involvement and fears for the future. Plans of care for assessed needs followed on from the initial assessments, under the same headings. There was evidence of care plans being reviewed and amended as needs changed. All sections had been dated and signed by staff. Risk assessments were in place for a range of areas such as risk of developing pressure damage, risk of challenging behaviour from other people using the service, moving and handling assessments, risk from low body weight and nutrition and hydration assessments. Where one person had lost weight, the care plan had been updated to reflect this, weekly weighing was taking place, a diet of soft foods was being encouraged and the person had seen the dentist due to problems with her dentures. It was encouraging to see care plans in place for activities. Peoples hobbies and interests had been identified and a personal profile and life history had been written. For one person whose faith was important to her, the information was noted in several places in the care plan file, including under activities, and she was being supported to attend church services held at the home each month and to see visiting clergy. Daily notes written by staff were detailed and up to date and gave a good account of peoples well being. Staff were maintaining records of visits by or appointments with health care professionals, and the outcome. Dietician involvement was taking place as needed. Medication practice in one part of the home was looked at. The storage room was secure with the key kept on the person in charge. Cabinets within the room were secure and locked when not in use. The thermometer in the room was registering a temperature of 25 degrees Celsius; there was concern that in the summer months the safe upper temperature for storing medication could be exceeded. In discussion with Care Homes for Older People Page 4 of 9 the manager and service manager about this, they advised that air conditioning is being looked into and a quotation had been obtained for this. Medication administration records were in good order. Sample staff signatures had been taken and photographs of people using the service were in the records file. Peoples allergies or any difficulties in administering medicines were noted. Two people were prescribed lorazepam 1 mg tablets as required. There were no individual protocols in place to explain under what circumstances the medication is to be given and the person in charge of this part of the home confirmed that no written protocols existed and that each senior on duty used their discretion. Where as required medicines are in use, we would expect to see individual written protocols in place to make sure that medicines are given in a consistent manner. A requirement is made to address this. The controlled drugs cabinet and register were looked at. The only point raised with the person in charge was storage of three items of jewellery in the controlled drugs cabinet, which is not to be encouraged. The complaints log was looked at. Four complaints had been recorded for 2008. Records showed each complaint had been investigated and the complainant responded to. A copy of the complaints procedure in the log book had an out of date address for the Commission for Social Care Inspection and this needs to be updated to make sure that people have the correct information to hand. The dementia care unit had recently had some refurbishment including the addition of a kitchen area in the dining room. This was a positive addition and staff commented that it made a significant improvement. Each person had their own bedroom with ensuite toilet and wash basin. Rooms had been personalised to different degrees. Corridors had been themed to provide interest with pictures and objects depicting historic events, outdoor pursuits, Hollywood and family. Several people were seen looking at the pictures or touching objects as they walked by. Some stopped and sat in the armchairs in the corridors and watched the world go by. The garden area was looking well maintained and could be seen from the lounge and dining room and whilst walking along the corridors. The manager advised that carpeting is to be replaced on the dementia care unit. Staff were observed to be patient and gentle in their interactions with people using the service and conveyed dignity and respect. The rota reflected that seven staff work on the dementia care unit during the day with four waking night staff. Staffing levels at the time of this visit seemed to be appropriate for peoples needs. The service manager advised that there were no vacancies for care staff at the home. A deputy manager had recently been appointed. She is an experienced nurse and has worked in care of older people in a management position and was undergoing her induction. The induction format for new staff was looked at as part of the inspection. This was a detailed format covering specific tasks for the first day and examples of what to do thereafter for the first week and then first six weeks. The induction record covered policies and procedures, training that needs to be covered, working with a mentor and general introduction to the home and working practices. Training records were looked at. These were filed under subject matter, not member of staff. It was not possible to track training undertaken by a sample of staff as files containing certificates had not been kept up to date and there were several certificates Care Homes for Older People Page 5 of 9 yet to be placed in files. A central overview record providing details of who had attended training could not be located. We would expect better organisation of training certificates to be in place by the time of the next key inspection. Since the last key inspection there has been a change of manager at the service. She is experienced in working in social care and has recently been registered with the Commission. Monitoring visits by the provider were taking place on a regular basis with reports available of the findings. Reports were detailed and showed that monitoring is of a good quality and focuses on outcomes for people using the service. The service manager was auditing care plans as part of her time at the home and set action where standards were not being met. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Individual protocols are to be 01/02/2009 written for any as required medicines. This is to make sure that staff administer such medicines in a consistent manner. 2 16 22 The complaints procedure is to be updated to reflect the revised contact details for the Commission for Social Care Inspection. This is to make sure that people have accurate information to hand. 01/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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