Inspection on 05/12/05 for Ashdene Care Home

This inspection was carried out on 5th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashdene Care Home 18/07/07

Ashdene Care Home 16/08/06

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 Unannounced Inspection 5th December 2005 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.V270003.R01.S.doc Version 5.0 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.V270003.R01.S.doc Version 5.0 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.V270003.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Service Users in the Category of DE must be aged 55 years and over. 22nd August 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. 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. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and started at 8.15 am. It took place over 4½ hours. The inspector spoke to 7 residents, 2 visitors, 8 staff, the deputy manager and the manager. The main method of the inspection 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 care was delivered. The inspector also observed how care was delivered and how staff responded to other residents living in the home. The inspector also examined a pre-inspection questionnaire, which had been completed by the manager. What the service does well: What has improved since the last inspection? Four bedrooms have been redecorated and recarpeted. New occasional tables have been purchased for the 2 lounges. A covered outside area has been provided for those people who may wish to smoke, as the home is non smoking. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 6 A roving microphone has been provided to enable residents to actively take part in musical/entertainment activities. New flooring has been provided in one of the toilets. A training room has been provided for staff. 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.V270003.R01.S.doc Version 5.0 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.V270003.R01.S.doc Version 5.0 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, 2, 5 and 6 Ashdene Care Home meets the needs of residents coming into the home. People receive an assessment, which results in their needs being met. Residents receive information to enable them to make a choice as to whether or not they wish to come to this home. EVIDENCE: All residents are assessed before entering the home and written confirmation is sent to them that the home is able to meet their needs. There is a detailed statement of purpose and service user’s guide. Both of these documents had just been reviewed. A copy of the service user’s guide is given to each person when being admitted to the home. Each resident receives detailed terms and conditions when moving into the home. Staff receive a comprehensive induction programme, which enables them to understand the needs of the residents in the home. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 9 One recently appointed new member of staff commented, “I received a well planned induction and felt supported and guided during my induction People coming into the home can have a trial stay of up to 8 weeks to see whether or not they like the home. An assessment is made during this time. The home does not provide intermediate care. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 11 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. The home provides support to residents and their relatives at time of death. EVIDENCE: All residents had detailed and up to date care records. These included assessment details, personal profile this includes a statement concerning how the person’s life could be improved, 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 is delivered by 3 teams of key workers. The home receives a visit from a Consultant Psychiatrist every 2 weeks. Care plans showed evidence of promoting resident’s independence, respect, dignity and choice. This was confirmed by residents and observed during the inspection. Staff were seen to speak to residents a number of whom were frail, in a calm and gentle unhurried manner. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 11 Residents commented “I like it here” and “I am very happy”. There was a calm and unhurried atmosphere in the home. Staff receive training on how to care and support those residents who are dying and to their relatives. The home also has a detailed policy concerning death and bereavement, which gives guidance to staff. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 A wide range of social activities are available to provide stimulation and interest for people living in this home. Meals provided are nutritious, balanced and offer a varied diet. Visitors are made to feel welcome and supported and can visit whenever they wish to do so. EVIDENCE: All care records outlined what the residents liked to do and their interests. There is a safe and stimulating enclosed garden area with raised gardens, potting shed and seating areas. An activities programme for December 2005 was displayed on the notice board at the entrance to the home. Activities planned included tea dance, family tea, and visits by local schools, a carol service and Christmas party. The home employs an activities organiser. During the inspection a resident was going swimming at the local swimming pool accompanied by his key worker. The home was decorated with resident’s artwork, Christmas decorations, pictures, and plants. There was also quiet relaxing music being played in the lounge/dining room. No resident showed any form of distress and staff sat with them. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 13 Residents said they enjoyed the food in the home. Visitors commented,” the staff are so helpful, kind and friendly” and “the manager is superb”. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 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. A member of staff knew what abuse was and what they should do if abuse was suspected. All staff receive abuse training during their induction. Visitors commented, “I have confidence in the staff and feel I can discuss anything if I have any worries”. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 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 the following standard(s): 19, 21, 22, 23, 24 and 26 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. The physical environment has been developed in consultation with the Stirling University Dementia Research Centre in Scotland. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 16 There are 4 toilets, none of which are in bathrooms on the ground floor. On the first floor there is one toilet and a toilet in a bathroom. None of the bedrooms are en-suite. There is also one visitor and one staff toilet. There are 2 bathrooms on the ground floor and one on the first floor. All of these facilities have locks. Signs have been introduced to aid service users orientation. All bedrooms meet the minimum size requirements. The home has 4 shared bedrooms. Thermostatic controls have been installed to all washbasins and bathrooms throughout the home. Radiator covers have also been installed to give a guaranteed surface temperature not exceeding 43º Centigrade. Hot water temperatures are tested every month and adjustments made where they exceed the above temperature. The home employs separate staff for domestic and laundry duties. The home has an infection control policy and staff have gloves and aprons. There is an enclosed sluice and a sluice programme on one of the commercial washing machines. The home was clean and odour free throughout. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 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 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 and 28 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 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, “we have enough time to care for the residents and work as a team”, “the home continues to improve” and “I feel proud of the what I have done for these people”. There is an extensive training programme for staff, which includes training in care (NVQ), internal lectures and training from outside trainers. Staff also have received dementia awareness training. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 The home is well lead by a competent, experienced and committed manager. There is a confident, supported and trained staff team. The home has 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, 3 of her staff are also to study 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 October 2005 stated, “a lovely fresh environment” and “great friendly staff”. The registered provider makes monthly unannounced monitoring visits to the home. Detailed reports are sent to the Commission. Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 Page 19 As part of the quality assurance in the home, internal audits have been introduced since November 2005. These have covered the kitchen, accidents, care planning and medication. Action plans have been developed where issues have been identified. The home has detailed policies and procedures, which includes induction and training. Staff who spoke to the inspector told him of the benefit they had obtained from the sessions and training provided. The home had detailed policies and procedures, which include employment, induction and training. This enables staff to care and support residents. An outside consultancy has produced a new staff handbook. Staff receive formal supervision six times a year and an annual appraisal. New staff also receive a comprehensive structured induction programme. 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. Comments from residents were, “I am very happy here” and “staff are very kind”. 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.V270003.R01.S.doc Version 5.0 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 3 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 3 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 3 3 Ashdene Care Home DS0000002632.V270003.R01.S.doc Version 5.0 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.V270003.R01.S.doc Version 5.0 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: 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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