Inspection on 27/05/05 for Ash Court Care Home

This inspection was carried out on 27th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Ash Court Care Home 04/03/08

Ash Court Care Home 18/05/06

Ash Court Care Home 11/01/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashcourt Care Home Brookside Avenue Liverpool Merseyside L14 7NB Lead Inspector Pat Kearney Unannounced Tuesday, 24 May 2005 10.00 & Friday 27th May 11.00 th 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 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. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashcourt Care home Address Brookside Avenue Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 259 7522 Meridian Care Limited PC Care Home Only 37 Category(ies) of OP Old Age 37 registration, with number of places Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 15/12/04. Brief Description of the Service: Ashcourt is a purpose built home which was built 5 years ago.Ashcourt was January 2005 purchased by Meridian Care Limited .The manager has recently left and Meridian Care Limited are in the process of recruiting a new manager.The Deputy at the home is acting as manager. The home is located in a residential area of Liverpool and is within easy access to bus routes, churches and local amenities. There are two bedrooms on each floor that have intercommunicating doors. This facility is used for couples who wish to share, enabling one room to be used as a bedroom and the other as a lounge.The home is purpose built two storey building that was opened in 1999.There are 37 single bedrooms which all have en-suite facilities, telephone connection T.V. arial and a staff call system. There are additional toilets and bathrooms situated throughout the home.Communal space within the home consists of a conservatory and three lounge areas, one of which is equipped with facilities for service users/visitors to make their own drinks /snacks. There is a garden area at the front of the home and a small area to the rear which has a water feature for service users to enjoy. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 10 00 hours on 24th May 2005 and a second follow up visit on 27th May 2005 the acting manager was on duty at both times. The regional manager from Meridian Care Ltd who purchased the care home at the end of January 2005.was also present for part of the initial inspection. A full tour of the premises took place. The service users and their relatives expressed their concerns about the number and frequency of management changes that had taken place over the past two years. All relevant documentation for service users and staff were reviewed What the service does well: What has improved since the last inspection? Meridian Care Ltd has recently purchased the care home and achieved the Investor in People Award. The Regional Manager and Operations Director have informed C.S.C.I of the companies plan to completely refurnish and refurbish the home within the next 6 months. Four of the bedroom carpets have been replaced Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 6 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. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 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 standard(s) 1.2.3.4.5.6 The homes Statement of Purpose and Service User Guide is inadequate and does not provide sufficient information for prospective service users to be clear about the service the home provides to meet their care needs. Service Users are not informed about the complaints procedure when reading the Service Users Guide. EVIDENCE: Since purchasing the care home Meridian Care Limited have started the process of reviewing the Statement of Purpose and Service User Guide. Most of the information as listed in the National Minimum Standards (N.M.S.) is in both documents, however there was no detail about amount or method of payment of fees. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 9 Service users admitted to the home since Meridian Care Ltd had become the owners have been issued with a contract/ terms and conditions which are kept on their files. The newly printed Service Users Guide/ Brochure does not make reference to the homes complaints procedure or contain the address and telephone number if Service Users or their relatives wish to contact the Commission for Social Care Inspection (C.S.C.I.) The homes manager undertakes a pre admission assessment on residents before they are admitted to the home, to ensure all care needs are identified. Other health or social care professionals known to the resident are also involved in the assessment. Service users are able to visit the home several times with varying lengths of stay tailored to meet their individual needs before they decide to move in on a permanent basis. Relatives spoken to during the inspection who were viewing the home on behalf of a potential service user commented “How very helpful and welcoming the staff had been in showing them around the home and they felt they had gained a lot of useful information about the home” The home does not provide intermediate care. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 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 standard(s) 7.8.9.10.11. Care plans do not show a clear or consistent approach to recording information Daily recordings lack information about visits by health care professionals and details about any other critical incidences making it difficult for the changing needs of service users to be met. Personal support in the home is not offered by all staff in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: All service users in the home have an individual care plan, which is formulated on admission to the home, reviewed monthly by the senior care staff. Records viewed showed an inconsistent approach to the care planning process and gaps in information were evident. There were record sheets in the care plans with the name of another establishment not part of Meridian Care Ltd. Daily records are documented daily for each service user, while these show improvement since the last inspection more detail is still required to record critical incidences plus any visits from GPs, specialist nurses etc. One service user in the home self medicates and a risk assessment has been completed. Medications are administered by the senior care in the home. The Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 11 protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). Service users and relatives told the inspector that the majority of staff treat them with dignity and respect but that “Just the odd one is sharp and impatient” with them. One relative commented that “Some staff rush Mum and snap at her which upsets her” The resident’s documentation is kept secure in accordance with the Data Protection Act 1998. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 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 standard(s) 12.13.14.15. The meals provided, during the week are good - offering both choice and variety and catering for special dietary needs however staff shortages at the weekend has meant a deterioration in the standard of meals being provided at the weekend Organised social activities for residents are not being undertaken on a daily basis in the home, this may lead to boredom, frustration and apathy amongst the residents. EVIDENCE: Service Users said “they were able to choose how they spend their time” and visits from relatives and friends are encouraged. The activities organiser has recently left the home which has meant that there is not a structured activities programme at the home. Several services users commented that they “missed the arts and craft sessions which they had enjoyed very much”- and that” they would like more activities in the home” . Visitors spoken to on the day of the inspection told the inspector that” they were able to visit at any time and that they were always made welcome” and were able to have refreshments while at the home. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 13 The visitors told the inspector that they “ are kept informed of any changes in their relatives condition” Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 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 standard(s) 16.17.18. Complaints procedures are in place in the home, and residents spoken to are confident that their concerns will be listened to, taken seriously or acted upon. Staff have a working knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a complaints procedure, and a complaints record. No internal complaints were recorded in the last year, but two complaints were received by the C.S.C.I. prior to this inspection. On the day of the inspection a relative approached the inspector with a further complaint which was also investigated. Of the three complaints received one was upheld and two were unfounded. A copy of the complaints procedure is placed in each of the Service users bedroom. Service users and their relatives told the inspector that they were “Able to raise any issues of concern with the senior staff and they would be addressed” Relatives told the inspector of specific issues which they had informed the Deputy Manager about and “commented she was very helpful and the issues were resolved quickly” The Deputy Manager has undertaken Adult Protection training and showed an in depth knowledge of the Protection of Vulnerable Adults.( POVA). Staff have also completed Adult Protection training. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19 20 21 22 23. 24. 25.26. The overall fabric of the building is of a good standard, with most resident’s rooms being highly personalized. However an ongoing programme of redecoration and refurbishment must address the issues identified during this inspection. EVIDENCE: Ashcourt has been opened for 6 years the furniture, furnishings and decoration are in need of replacing or upgrading. Carpets in the lounges are stained, worn and in need of replacing. The tiles on the kitchen walls and floor require a thorough cleaning as they are marked and greasy. Service Users bedrooms require a through cleaning and some furniture and fittings need replacing the bedrooms and en suite bathrooms need to be de cluttered. Service Users and their visitors commented to the inspector that “Bedrooms are not always cleaned thoroughly” one relative commented that Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 16 “The bedroom had never been redecorated for the past 6 years, which is not something that would of happened when she was at home” The shortage of cleaning staff over the past couple of months has affected the standard of cleanliness at the home. A number of the bedrooms and communal spaces were untidy, carpets were stained and surfaces marked and sticky. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 A period of considerable instability in management at the home has resulted in low staff morale, high staff turnover and poor attendance that has had a detrimental impact on the standard and consistency of care offered within the home. Staff personnel files did not contain all the appropriate documentation needed to ensure the health and safety of both residents and staff. EVIDENCE: Since the last inspection there has been a large turnover of staff and this has had an impact on the quality of care provided. Service Users and their visitors commented on the number of “New faces at the home” others said “that they were very disappointed that the manager had left without informing them” Several Service Users said how much “they missed the activities particulary the arts and crafts “ Staff personnel files showed that staff training was taking place, however the certificates did not specify what Mandatory training had been completed. The home currently has no registered manager although the deputy manager who is acting manager has many years experience working with the Service User group and holds N.V.Q Level 4 Registered Managers Qualification. Service Users and their relatives commented “that the Deputy Manager is always Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 18 helpful and approachable “ “ She is lovely and very caring”. Service users were “Anxious about the staff changes and concerned that the Deputy Manager would leave” Meridian Care Ltd are currently in the process of reviewing and updating all policies and procedures at the care home and introducing their own corporate recruitment and selection policy The recruitment and selection policy was not available on the day of this inspection. Meridian Care Ltd have developed job specific training manuals which all staff are expected to complete. These are currently being introduced at Ashcourt. Meridian Care Ltd have recently gained the Investor in People Award. Staff personnel files viewed did not contain all the relevant documentation as required. Training certificates lacked detail about the specific training completed. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 36 37 38 After a period of considerable instability in the management of the home, staff morale is low with high levels of sickness and staff turnover. This has had a detrimental impact on the health safety and welfare of service users and staff. EVIDENCE: The home does not currently have a Registered Manager the former manager left at the beginning of May, The home has had 5 different managers in the past two years this has caused the service users to feel unsettled and anxious. Service Users” told the inspector that the many changes of management of the past 2 years was very unsettling “”We are not sure who is taking care of us ”Relatives commented that “there has been constant change at the home and it was difficult for all concerned “ The Deputy Manager is currently acting manager and has many years experience working with the service user group and holds the N.V.Q. Level 4 Registered Managers award. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 20 On the day of the inspection there was an incomplete set of corporate documentation available for Meridian Care Ltd. This could lead to confusion and lack of clear direction for the staff group. Some quality assurance is in place, with feedback and minutes of staff and Service Users meetings kept. The recent departure of the manager has had a detrimental effect on service user and staff morale. Service Users commented that “Its very unsettling we don’t know who is in charge” “ There have been so many changes since I have been here. “ Patient’s monies are kept in separate, secure facilities, and records of all transactions were seen. On the day of the inspection the Portable Appliance Testing has not been completed and the certificate was out of date. The inspection was completed and the copy of the certificate was forwarded to the C.S.C.I office by 13th June 2005.Other annual contracts were in date Meridian Care Ltd have recently achieved the Investor in People Award and the Regional Manager who was present at the inspection told the inspector “that the company is committed to ensuring that the home achieves the best possible standards of care for services users and that staff will receive ongoing opportunities for training and development”. The Regional Manager told the inspector that Meridian Care was planning a total refurbishment of the home. This was confirmed in writing by the Operations Director to C.S.C.I. projecting that the company would be spending £400.000 on the refurbishment. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 2 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 2 3 3 3 3 3 2 Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? 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 1 Regulation 4 Requirement The Registered Person shall ensure that the Homes Statement of Purpose is updated and include the services and faciliites provided by the home for service users The Registered Person shall prepare a written care plan as to how the service users needs in respect of his health safety and welfare are to be met This must include detailed recording of daily events and record visits by health care professionals. The registered person shall ensure that the care home is conducted in a manner in which respect the privacy and dignity of service users at all times. The registered person shall ensure that organised activities for residents are faciltated in the care home, according to the choices and preferences of the service users.. The registered person shall provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at all times as F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Timescale for action 1/7/05 2. 7 15 1/7/05 3. 12 4 1/7/05 4. 12 & 14 16 1/7/05 5. 15 16 1/7/05 Ashcourt Care Home Version 1.30 Page 23 required by service users. 6. 19 23 The registered person shall ensure that the premises to be used as the care home are well maintained and furnished at all times both internally and externally - refer to overall poor state of the environment,internally and produce a planned programme of refurbishment and forward it to C.S.C.I. The registered provider shall make suitable arrangements for maintaining satisfactory standards of hygeine and cleanliness at the home. To include service users bedrooms and communal areas. The registered person shall ensure that at all times suitably qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health safety and welfare of the service users. The registered person shall ensure that all staff receive adequate training and clear records of this are kept. A person shall not manage a care home unless he/she has the qualifications skills and experience necessary for managing a care home.Following the six month probationary period the acting manager must apply to C.S.C.I to become the Registered Manager. 15/7/05 7. 25 16 15/7/05 8. 27 18 15/7/05 9. 38 23 15/7/05 10. 31 9 15/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 24 No. 1. Refer to Standard Good Practice Recommendations Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Liverpool Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Ashcourt Care Home F52 F02 S63424 Ashcourt V228164 240505 Stage 4.doc Version 1.30 Page 26 - 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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