Inspection on 18/07/07 for Ashdene Care Home

This inspection was carried out on 18th July 2007.

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 16/08/06

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 Tobias Payne Unannounced Inspection 18th July 2007 08:20 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.V343777.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.V343777.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 414568 ashdene@onetel.net 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.V343777.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. 16th August 2006 Date of last inspection Brief Description of the Service: Ashdene Care Home 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 26 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. At this inspection visit a large amount of building work was taking place to provide an additional 14 beds on the first floor and new facilities. The directors of the home visit regularly and work closely with the registered manager. The fees at the inspection on the 18/7/2007 ranged from £348 to £473 per week. Extras were for hairdressing which ranged from £5.50 to £22, chiropody £7.50, toiletries, personal newspapers and magazines and taxi fares. Information about the home can be obtained from the manager of the home. Ashdene Care Home DS0000002632.V343777.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 8.20 am. It was undertaken using a review of all the information available to us about Ashdene Care Home. We spoke with 8 residents, 5 staff and the deputy manager and manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. The inspector also examined an Annual Quality Assurance Assessment, which had been completed by the manager. Comment cards were received from 4 residents. What the service does well: What has improved since the last inspection? The home is undergoing a major extension which when completed will increase the number of beds and facilities in the home. Care records have been changed to identify the positive aspects of the residents’ life. A review has taken place of the way breakfast is served. This has enabled a more flexible and responsive service to be provided for the residents at breakfast. Fruit and savoury snacks have been introduced between meals. Vegetables tureens have been introduced for residents to enhance their independence. A wet /shower room has been provided to give more choice to the residents. Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Ashdene Care Home DS0000002632.V343777.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.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident coming into the home receives an assessment and know their needs can be met. There is information provided to enable them or their relative to make a decision whether or not to come into the home. EVIDENCE: There was a detailed statement of purpose and service user’s guide. The manager was aware that these would need to be reviewed in preparation for the extension, which will increase the number of beds from 27 to 40. Information was clear and detailed. The last inspection report was available in display shelving at the entrance to the home. Each person was assessed by the manager before being admitted to the home and the manager had recently reviewed the assessment form to make it clearer and obtain more information about the person coming into the home. Written confirmation was sent to confirm the home could meet their needs”. The home did not provide intermediate care Ashdene Care Home DS0000002632.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is very good person centred care planning in this home, which ensures the residents’ health and emotional needs were met. Medication is safely given by competent staff to ensure residents good health. EVIDENCE: Records were very comprehensive and person focussed. The manager had reviewed the way records were written with the emphasis on what the resident could do so emphasising the positive aspects of their lives. Records included assessment details, contract, written agreement about personal autonomy and choice, respect and dignity, personal profile, social and leisure, mental and physical health assessment, risk assessment and falls assessment, behaviour assessment, nutritional assessment, moving and handling, oral health, care plan agreement, monthly evaluation and review with resident and relatives comments and care plan. The care plan indicated the problem/need and the aim of the care plan. All entries were dated with the staff signature. Records were very detailed and person centred. Staff used them and clearly knew the needs of the residents. Throughout the inspection visit staff went about their work in a very professional manner. We saw staff talking, encouraging, Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 10 praising, directing, assuring, laughing and explaining calmly what they were doing. There were no signs of any residents being distressed. We spoke with residents who commented, “I like the home”; “they are so kind”. ”The staff are beautiful”, “they like to talk to me and are so lovely” and “I am very happy”. The home continued to receive a visit from a consultant Psychiatrist every 2 weeks. There were 10 named staff responsible for the administration of medication. All had received training about the safe way to administer medication. There were no concerns about the medication arrangements. Ashdene Care Home DS0000002632.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ social and cultural needs are clearly very well met at the home. There was a variety of nutritious food provided to ensure good health. Residents’ independence is promoted in many innovative ways. EVIDENCE: The home has an experienced and well motivated and knowledgeable activities person. There was an activities room. Each care plan had information about the residents’ social interests. On the notice board at the entrance to the home were posters with information about activities taking place in the home. This included, worship time (this was taking place on the day of the inspection visit), coffee morning, tea dance, monthly entertainer, Extend exercise class, prayer and share as well as craft activities. There was also a relative’s support group. The home also had a 6 monthly newsletter. The religious service was attended by most of the residents. Staff went to each person and asked them whether they wished to attend. One resident replied “no thank you I would like to sit here” and his wishes were respected. Other residents were walking around the home or sitting in chairs or dozing. Staff were ever present ready to talk and help them. We spoke to 2 relatives both were very satisfied with the care and support from the home. Comments were, “the home is brilliant, they could not have done any more, they are so Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 12 kind, sensitive and understanding” and “they always keep me fully informed if my mother has been unwell”. There were no negative comments. Residents’ artwork was displayed along the corridor and throughout the home. The home was in a state of great change with a large extension being built which had understandably caused some disturbance to the home. The last Environmental Health Officers inspection was on the 9/7/2007 when the home was awarded 3 stars (very good) by South Kesteven District Council. There was a drop of one star mainly as a result of the decorative state of the kitchen. The kitchen will be repainted and modernised after the extension during 2008. New initiatives continued to be introduced for the catering service. These had included providing vegetable tureens and tea trays for some residents to enable/promote their independence and pride. In addition, at breakfast an additional member of staff had been provided in the dining room. This person supervised and asked each resident what they wanted to have for breakfast. This had created a less stressful atmosphere and more flexibility. All residents and visitors were satisfied with their meals. Ashdene Care Home DS0000002632.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to make a complaint and feel that staff will listen to their views. Staff are aware of how to respond to a complaint or an adult protection allegation to ensure that residents are safe guarded. EVIDENCE: There was a complaints procedure displayed at the entrance to the home and each person received a copy of the complaints procedure in the service user’s guide. The home and the commission had received no complaints since the last inspection. No one had any complaints about the home during the inspection. Staff were correctly recruited with application form, references obtained, and induction. Staff knew about abuse and their role and training had been provided for all staff during their induction with follow up training. Ashdene Care Home DS0000002632.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People lived in comfortable and safe accommodation. Efforts had made to ensure that as little distress was caused to the residents during major building works taking place. EVIDENCE: A 14 bed extension was being built and hoped to be open December 2007. This had caused considerable disturbance in the home and the home was as a result of this not up to its normally high standards of cleanliness. However despite this there was nothing to show this was causing any distress to the residents. The carpets in the corridors and entrance were marked with dust. However when all the external work had been completed, new carpets were to be laid throughout the corridors in the home and the ground floor repainted and new lighting provided. In addition a sensory room would be provided, the kitchen refurbished and gardens landscaped. Residents and visitors had been kept fully informed of the development and considerable effort had been made to ensure that it did not affect residents. The home was odour free Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 15 throughout. There were lounge and sitting areas throughout the home. Since the last inspection visit a wet room/shower room had been provided to give more choice to the residents. Signs had been provided to residents’ bedrooms, toilets and bathrooms to help them find their way around the home. Colourful murals were in one bathroom and the lounge. The physical environment had been developed in consultation with the Stirling University Dementia Research Centre in Scotland. Ashdene Care Home DS0000002632.V343777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are protected by robust recruitment practices. Residents benefit from a staff team who are well trained, skilled and know how to deliver a person centred approach to care, work well together and compliment each other’s skills. EVIDENCE: Recruitment records for a new member of staff were examined. There was evidence of an application form, 2 references, Criminal Records Bureau check, induction and details of training. Comments from staff were “ I have found everyone so helpful”. All staff spoke of working as a team. Staff and visitors felt there were sufficient staff in the home. The manager monitored dependency and was able to employ more staff where required. Ninety five per cent of staff had qualifications in care (National Vocational Qualifications). All staff demonstrated a skilled approach to dementia care. This was shown throughout the inspection visit by their ability to understand and communicate with all residents. Training since the last inspection had covered, epilepsy, understanding dementia care, dementia care in a care home, fire safety, activities, mini-mental test, moving and handling, scabies and clostridium difficile. The home was awarded the Investors in People on the 3/3/2005. We spoke to two members of staff, both commented on the benefit they had obtained from the training. Comments were “I am now more confident and I now have the skills to understand and care for people. This has boosted my Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 17 self confidence and esteem” and “I enjoy working here and have learnt so much”. Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a competent, innovative, committed, experienced manager. This has lead to a very confident, supported and trained team of staff. Quality is very well addressed seeking the views of residents, visitors and professional staff to ensure rights and standards are maintained. EVIDENCE: The manager had extensive care and management experience and had a care and management qualification. Her knowledge in delivering innovative approaches to care had enabled her to deliver Dementia training across Lincolnshire in conjunction with the work force study group. She was about to start a Bsc Hons in Dementia Studies in September 2007. Staff and residents and visitors had total confidence in the manager. Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 19 Staff received supervision regularly and spoke of the support received from the manager and deputy manager. There was a comprehensive quality assurance system established. The manager carried out internal audits every month on the environment, kitchen, accidents, care planning, medication, pressure sores, hoists and the weight of residents. The last residents survey was sent out on the 11/7/2007. Four had been received at the inspection visit. Comments were, “I am most impressed with the care, always extremely clean”, “Am always kept informed of any incidents”, “my relative wants for nothing”, “I have found her well looked after by caring staff” and “I think the staff work extremely hard, work well together, are very friendly. Their work is not easy but I admire them for their care and patience, especially during this period while the building is in process. “I must add praise for Ann whom I feel is a wonderful manager”. The home had also sent out a questionnaire to community nurses, GPs and chiropodists. Very positive comments were received. The directors also made monthly unannounced monitoring visits. We examined the homes comment/complaints book at the entrance to the home. Sample comments were, “pictures (especially the large one in the lounge) fantastic, brightens the place up. Very well done”, “amazing as always, thanks to all for the patience that is evident”, “mother has been here for a year. I can’t thank Ann and her team enough for the way they have helped her. The kindness of staff and patience has been wonderful”. There were no negative comments. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. The inspection showed that each resident’s person hood and diversity was covered. There were no concerns about equality and diversity. There were also detailed and up to date health and safety policies. Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 20 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 X 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 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 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X X X 3 Ashdene Care Home DS0000002632.V343777.R01.S.doc Version 5.2 Page 21 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.V343777.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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