Inspection on 16/08/06 for Ashdene Care Home

This inspection was carried out on 16th August 2006.

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

Ashdene Care Home 18/07/07

Ashdene Care Home 05/12/05

Ashdene Care Home 22/08/05

Ashdene Care Home 16/03/05

Ashdene Care Home 07/07/04

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

CARE HOMES FOR OLDER PEOPLE Ashdene Care Home 89 Eastgate Sleaford Lincs NG34 7EE Lead Inspector Mr Toby Payne Key Unannounced Inspection 16th August 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 Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashdene Care Home Address 89 Eastgate Sleaford Lincs NG34 7EE 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) 01529 304872 01529 415568 Ashdene (Sleaford) Limited Mrs Anne Barwell Care Home 27 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (27) of places Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Service Users in the Category of DE must be aged 55 years and over. 5th December 2005 Date of last inspection Brief Description of the Service: Ashdene Care Home is a care home, which is registered to provide personal care for up to 27 service users who have a dementia and are over 65 years of age. On the day of the inspection there were 27 people living in the home. The home is situated on the outskirts of the town of Sleaford within walking distance of the town centre. The home is a converted 3 storey building with a single storey extension. Accommodation for people living in the home is on the ground and first floor. A shaft lift serves the first floor. There are 19 single and 4 shared bedrooms none of which are en-suite. There is car parking available at the front of the home. Ashdene is set in its own grounds, which are laid to lawn at the front with an enclosed garden with seating, trees and flowerbeds at the rear of the home. There is also an enclosed seating area with raised gardens with access at the side of the home. The directors of the home visit regularly and work closely with the registered manager. The fees at the inspection on the 16/8/2006 ranged from £335 to £457 per week. Extras were for hairdressing which ranged from £5.50 to £20, chiropody £7, toiletries, personal newspapers and magazines and taxi fares. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.30 am. It was undertaken using a review of all the information available to the inspector about Ashdene Care Home. It took place over 6½ hours. The inspector spoke to 7 residents, 3 visitors, a visiting community nurse, 5 members of staff and the manager. The main method was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. What the service does well: People living in this home are cared for by a well managed, educated, committed and competent care team. Those residents and 3 visitors who were spoken too expressed satisfaction with the care and service provided by the home. All residents are assessed before entering the home and there is a suitable, varied recreational and activity programme provided which provides stimulation. There is active involvement of the local community in the activities taking place in the home. There is a thorough assessment and review of care with wherever possible resident and relative/family involvement. There is a comprehensive programme of education provided which ensures that staff know how to care and support people living in the home. People living in the home live in clean, well decorated, attractive accommodation. There are safe and accessible gardens provided to enable people to enjoy the outside of the home in safety. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Ashdene Care Home meets the needs of residents coming into the home. People receive an assessment, which results in their needs being met. EVIDENCE: All residents were assessed before entering the home and written confirmation was sent to them that the home was able to meet their needs. There were detailed records available to show this had taken place for a person who had recently come to the home. There was a detailed statement of purpose and service user’s guide. Both of these documents had been reviewed to make them easier to read. A copy of the statement of purpose was displayed with other information at the entrance to the home. A copy of the service user’s guide was given to each person when being admitted to the home. The home did not provide intermediate care. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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, 9 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is a clear, person focussed and detailed care planning system in this home. This ensures that the health and welfare needs of people living in the home are fully met. EVIDENCE: All residents had detailed and up to date care records. These included assessment details, personal profile including past life, interests and hobbies, physical and mental abilities, health and hygiene, risk and moving and handling assessments, dental, nutritional and daily living assessments as well as a comprehensive care plan and daily record. Care plans showed evidence of being reviewed monthly. They were also focussed on the needs of the individual resident. Care was delivered by 3 teams of key workers. The home receives a visit from a Consultant Psychiatrist every 2 weeks. A visiting community nurse commented, “This home has improved a lot, staff are very competent and know about the needs of the residents. There is also good communication between the home and our service”. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 10 Care plans showed evidence of promoting resident’s independence, respect, dignity and choice. Residents and visitors to the home confirmed this. Residents commented, “ I am very happy here” and “the staff are kind”. There was a calm and unhurried atmosphere throughout the home. There were 10 care staff who were responsible for the administration of medication. All these staff had received training in order to ensure they knew what they are doing. Staff were seen to attend to residents many of whom were physically and mentally frail in a kind and sensitive manner. Talking to them, using their name and encouraging them to remain independent. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. A wide range of social activities were available to provide stimulation and interest for people living in this home. Meals provided were nutritious, balanced and offered a varied diet. Visitors were made to feel welcome and supported and could visit whenever they wished to do so. EVIDENCE: All care records outlined what the residents liked to do and their interests. Social interests were identified in the care plans and an activity programme was available. The activities person was on annual leave but care staff was carrying out activities. At the entrance to the home were posters outlining a wide range of activities including, Extend exercise classes, tea dances, act of worship, pension service advice, outside entertainers and coffee mornings as well as craft activities. The home also had a 6 monthly newsletter. There was an active relatives support group. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 12 Craft work was taking place and there was a musical entertainer playing an electric organ in one of the lounges in the afternoon on the day of the inspection. Three relatives were spoken to and all felt very satisfied with the care and support from the home. There was a safe and stimulating enclosed garden area with raised gardens, potting shed and seating areas. The garden areas continue to be developed with the flower beds having flowers planted by the residents. Residents were sitting in the garden or safely walking around the garden with one another. The home was decorated with resident’s artwork. No resident showed any form of distress and staff sat with them. The kitchen was clean and tidy as it has been on previous inspections. Food records, temperature records and cleaning records were examined. There were no concerns. Breakfast and lunch was observed and there was a pleasant and relaxed atmosphere. Tables were laid with clean table cloths and flower arrangements. The menu was written on the whiteboard in the dining room. A new initiative had been introduced in the last couple of weeks of providing trays of tea and cups to a number of tables to enable those residents to be independent. This was seen to be very innovative and successful with residents helping one another and offering a cup of tea to the inspector. All residents were satisfied with the food. The home was awarded 4 stars (very good) for its catering service by North Kesteven District Council in July 2006. Residents said they enjoyed the food in the home. Visitors commented, “I visit the home regularly and am always made to feel welcome. I am very impressed with the way the staff attend to my husband and I attend the relative support group which has been very helpful” and “we are so impressed with this home. We are kept fully informed and always find the staff so caring and supportive”. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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 and 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Complaints received are treated properly and residents and visitors know that any complaints they have to make will be addressed and taken seriously. Staff are recruited to ensure that residents are protected from abuse. EVIDENCE: Since the last inspection, no complaints have been received by the home or the CSCI. Each resident received a copy of the complaints procedure with the service user’s guide. Several members of staff knew what abuse was and what they should do if abuse was suspected. All staff receive abuse training during their induction. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents live in clean, well decorated, well maintained and safe accommodation. The design allows residents with poor memory to find their way around. EVIDENCE: Residents and visitors who spoke to the inspector said how satisfied they were with the decoration and cleanliness of the home. Bedrooms were individual with pictures, ornaments, photographs and personal mementoes. All bedrooms had locks to provide privacy but to allow staff to enter in case of emergency. Signs have been provided to resident’s bedrooms, toilets and bathrooms to help residents find their way around. A colourful mural has been provided in one of the bathrooms. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 15 The physical environment has been developed in consultation with the Stirling University Dementia Research Centre in Scotland. The home employed separate staff for domestic and laundry duties. The home had an infection control policy and staff had gloves and aprons. There was an enclosed sluice and sluice programmes on both of the commercial washing machines. The home was clean and odour free throughout. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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): 27, 28,29 and 30 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. There was a well trained and competent staff team. The number of staff was sufficient to meet the needs of the residents. Staff are correctly recruited. EVIDENCE: None of the residents, visitors or staff expressed any worries about the level or availability of staff. During the inspection, staff were seen to attend to residents promptly. Staff commented, “there is a lot to do but we have enough time to care for the residents and work as a team”, “we are offered a great deal of training” and “it is fun working here”. All staff had received checks by the Criminal Records Bureau and new staff had been recruited in line with the requirements. There was an extensive training programme for staff, which included training in care (National Vocational Qualifications), internal lectures and training from outside trainers. Staff also had received dementia awareness training. Ninety eight per cent of care Staff had either achieved or were working towards a qualification in care (NVQ). Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. The home is well lead by a competent, experienced, innovative and committed manager. There is a confident, supported and trained staff team. Resident’s money is safely and securely looked after. The home had comprehensive and up to date policies and procedures. EVIDENCE: The registered manager has extensive care and management experience and has completed a recognised management qualification. In addition, 2 of her staff were also studying for a management qualification. The home provides a comment book at the entrance to the home. This invites any comments visitors would like to meet. Sample comments from March and July 2006 stated, “The care here is excellent and any person needing care is Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 18 very fortunate to find themselves here. The staff also care for families as well as clients” and “This home goes from strength to strength and has excellent leadership skills demonstrated”. The registered provider makes monthly unannounced monitoring visits to the home. Detailed reports are sent to the Commission. As part of the quality assurance in the home, internal audits are carried out every month. These have covered the environment, kitchen, accidents, care planning and medication and pressure sores. Action plans have been developed where issues have been identified. A resident’s relative’s questionnaire is sent out every 6 months and 13 were returned in February 2006. Positive responses were received. Comments were, “I am well satisfied with the care given”, “I feel my mother is well cared for and I appreciate the way staff keep in touch, staff are helpful, appear cheerful and show patience to the residents” and “thank you for the opportunity to discuss general items at the support group meeting”. A questionnaire was sent out in June 2006 to GPs, community nurses, chiropodist and hairdresser. Positive responses were also received. NKDC awarded the home 4 stars (very good) for its catering service. The home had detailed policies and procedures, which included induction and training. Staff who spoke to the inspector told him of the benefit they had obtained from the training provided. Resident’s monies were safely managed for all the people. Each person had a page with what has been spent, balance and signature. The manager also audits them. Staff received formal supervision six times a year and an annual appraisal. Comments from staff were “we work as a team”, “when I go home I know I have done a good job” and “management are very supportive and helpful”. Records examined on the day of the inspection were well maintained, up to date and kept securely. The home has a detailed health and safety polices which include COSHH (Control of Substances Hazardous to Health), Legionella and risk assessments where required. Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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 3 x 3 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 Page 20 No 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. 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 Ashdene Care Home DS0000002632.V306306.R01.S.doc Version 5.2 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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