Inspection on 15/08/07 for Ashdown Nursing Home

This inspection was carried out on 15th August 2007.

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

Ashdown Nursing Home 22/04/10

Ashdown Nursing Home 22/02/10

Ashdown Nursing Home 02/07/09

Ashdown Nursing Home 09/07/08

Ashdown Nursing Home 20/11/06

Ashdown Nursing Home 13/04/06

Ashdown Nursing Home 13/09/05

Ashdown Nursing Home 24/05/05

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOMES FOR OLDER PEOPLE Ashdown Nursing Home 2 Shakespeare Road Worthing West Sussex BN11 4AN Lead Inspector Mrs S Gawley Unannounced Inspection 15th August 2007 09:30 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 Ashdown Nursing Home DS0000062422.V348970.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. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashdown Nursing Home Address 2 Shakespeare Road Worthing West Sussex BN11 4AN 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) 01903 211846 01903 208680 Newcare Homes Ltd Michael John Rootes Care Home 40 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0) of places Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. Mental disorder, excluding learning disability or dementia (MD). The maximum number of service users to be accommodated is 40. Date of last inspection 20th November 2006 Brief Description of the Service: Ashdown Nursing Home is situated in a residential area of Worthing in West Sussex. The registered providers are Newcare Homes Ltd who purchased the home in 2004. Ashdown is registered for 40 residents over the age of 65 years who have dementia. The Statement of Purpose continues to be updated to show the changes to the home as it is being refurbished. The improved communal areas consist of a lounge and a lounge/dining room on the ground floor and a second lounge on the first floor. There are other small sitting areas in the entrance hall and upper and lower corridors, which lead to bedrooms. A passenger lift is available for rooms on the upper floor. There is a garden to the rear of the property, which is not currently available for use by residents. The current scale of fees being charged at the home is from £500 to £650 per week. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit as part of the inspection process took place on the morning and afternoon of 15 08 07. The newly registered manager was not present on the day of the inspection and the deputy manager facilitated the inspection. The commission was in receipt of an Annual Quality Assurance Assessment (AQAA) and any documents required on the day were made available. Information on file with the Commission was also considered. Four residents were case tracked, their care plans and medicine administration charts were inspected. These residents were not able to communicate their opinion on the home. A resident spoken to in the lounge stated that the staff were marvellous. One relative was spoken to on the day and she expressed satisfaction with the home. She stated that the staff were approachable and any concerns were dealt with. A further relative was spoken to on the telephone who could not speak highly enough of the home. A social worker was spoken to who stated the she feels the home has been working very hard to improve and that she feels very positive about it. The Commission was in receipt of 8 surveys from relatives all of which were positive, one commented “ I am extremely fortunate to have found such a comfortable and caring home for my Mum” and another commented, “ the food is very good and has improved greatly” Staff spoken to confirmed the improved training opportunities. What the service does well: From comments made on surveys and the comments of one resident it is clear that residents benefit from being cared for by kind and sympathetic staff. Staff were observed treating residents in an appropriate and respectful manner. The care offered is individual and promotes independence. One relative stated that her mother could now sit unaided having been admitted bed-bound and that her care is under constant review. Ashdown Nursing Home DS0000062422.V348970.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. The summary of this inspection report can Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 8 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 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 9 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): 3, Residents’ needs are fully assessed prior to admission. People using this service experience good outcomes in this area because need is fully assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose is still under review to reflect the ongoing changes in the home. Three residents were case tracked. The care plans inspected showed a comprehensive pre admission assessment. There is new documentation in place to facilitate this. Prospective residents and their relatives are invited to visit the home prior to admission. Ashdown Nursing Home does not offer intermediate care. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 10 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 11 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): 7-10 Residents have a comprehensive plan of care documented. The resident’s health care needs are met. Medication is safely stored and administered in the home. Resident’s privacy and dignity is respected and protected by the staff. People using this service experience good outcomes in this area because the care offered is individual and promotes independence and there has been an improvement in the recording of care needs being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were inspected and they had up to date information on care needs, including mental health needs and record of how these needs are met. There is a key worker system in place and they are responsible for updating care plans and ensuring continuity of care. Staff spoken to demonstrated an awareness of the key worker system and its underlying principles. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 12 Daily records are made on all plans. The Community Mental Health team supports the home and interventions are recorded. The homes policies and procedures for the management of medication promote safe practices. There is frequent medicines review with evidence of a reduction in major tranquiliser use following admission and an improvement in mental state. One resident admitted in very poor condition showed improvement in physical and mental state following admission. This was confirmed in discussion with a relative who said that her mother could now sit unaided having been admitted bed-bound. Her mental state is also much improved and she stated that her medication is under constant review. Medicines are appropriately stored, administered and medicine administration charts are up to date. A general Practitioner attends weekly to do medicine reviews and is called as is necessary if medical need arises. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 13 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): 12-15 The lifestyle offered in the home does not meet all resident’s needs and preferences. Residents can maintain contact with relatives. Visitors are welcome and residents enjoy a nutritious diet. People using this service experience adequate outcomes in this area because it was unclear how residents can exercise autonomy and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussion with staff it was established that the routines of daily living are not very flexible with breakfast lunch and supper times being served at very fixed times, “ supper time is 5pm sharp” Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 14 Residents are encouraged to maintain contact with family and friends and the deputy manager stated that the Roman Catholic priest visits once a month. There was not a programme of activities on display but the deputy manager stated that the care staff do activities with residents in the afternoon between 2-4pm. Some staff are doing activities training which does cover activities with people with dementia. Social need is not always clearly recorded in care plans. A Visitor spoken with during the visit confirmed that the staff made her “very welcome” and that she could visit the home whenever she wanted. She said she has not witnessed many activities but has been only coming for the past month. Another relative commented in a survey that the home is so welcoming she still visits although her relative is now deceased. It is not clear how personal autonomy and choice is exercised. Choice in meals is not routinely offered. One main course is offered at meal times and staff state that should a resident not like this then an alternative will be prepared. A four-week menu is in place and the lunch seen served appeared nutritious, was served in an appropriate format and was well presented. A relatives survey commented that food has improved greatly of late. Those residents requiring help were offered this in an appropriate and respectful manner. The homes AQAA states that a pictorial menu is being developed to enable residents to make a choice. Residents in the lounges were observed being offered drinks, for those in their rooms it was unclear how this need was met as there were no drinks available in the rooms. This was discussed with the deputy manager who stated that she was confident that these residents would be offered tea by staff and that the distribution of jugs may have been delayed today. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 15 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): 16,18 Complaints made by residents and their relatives are listened to, taken seriously and acted upon. All staff have received training to ensure residents are protected from abuse. People using this service experience good outcomes in this area because they are protected by the homes policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear complaints procedure on display in the entrance hall assuring residents, relatives and visitors that all complaints will be taken seriously and acted upon. Two relatives spoken to stated that they were aware of the procedure. Complaints records were available and these showed that complaints are dealt with appropriately and within the published timescales. Adult protection policies procedures were in place according to West Sussex Guidelines. Staff and training records show that all staff have now had Adult Protection training. Staff spoken to demonstrated an awareness of procedures to follow in the event of an allegation. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 16 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 17 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): 19,22,26 Residents do not live in a completely safe and well-maintained environment. Specialist equipment to promote independence is available. The home is clean and hygienic. People who use this service experience adequate because although work is ongoing not all areas are completed as yet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and pleasant throughout. The communal areas, which include the entrance hall, main lounge, small dining room and upstairs lounge, Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 18 have been refurbished and were comfortable and have good quality furnishings in them. Old tip back chairs have been removed and replaced with new recliner chairs. Staff spoken with were very pleased with the environmental improvements to the home, as was one relative. The majority of the bedrooms have been refurbished, beds are being replaced and the home has purchased more pressure relieving equipment. Screens are available on each floor for use in shared rooms. Two of the bathrooms are to be refurbished and the baths have been delivered to complete this. It is the intention to create a walk in shower room. Two new sluices have been installed and some windows have been replaced Four new wheelchairs have been purchased. Radiators are covered and taps have temperature control valves. A record of temperatures is kept and was available for inspection. A new call bell system has been installed. Grab rails have not been fitted as yet to all corridor areas. The exterior is not currently safe and accessible to residents but plans are in place to improve this by creating a courtyard and garden area with increased parking. Although much still needs to be done it is evident that the home has been working hard to meet the requirements of the last inspection and to make the home more safe and pleasant for residents and staff. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 19 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): 27-30 Residents’ needs are met by an appropriate number and skills mix of staff. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. People using this service experience good outcomes in this area because residents are looked after by appropriately trained staff This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA received stated that the overall staffing levels have increased and there is a larger number of registered nurses employed. The home is working towards having a minimum of 50 of carers completing the National Vocational Qualification level 2. During the inspection there were adequate numbers of care staff on duty to meet residents needs, although one staff member was off sick. Staff spoken to confirmed that there were training opportunities in the home. A training programme was seen which had training Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 20 for medication, manual handling, infection control, first aid, COSHH, food handling, fire and dementia. Staff files inspected during the inspection contained all the documentation required. Relatives and a resident spoken to stated that staff are at all times kind and respectful. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 A person fit to be in charge manages the home. The home is being run in the best interests of the residents. The registered provider has ensured that residents’ financial interests have been safeguarded. The health, safety and welfare of residents and staff are protected. People who use this service experience good outcomes because the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has recently completed the registration process with the Commission and was deemed fit for registration. There is also a deputy manager in place and an administrator has been employed to keep documentation up to date. The home has met the requirements of the last inspection. Documentation was available to evidence that residents receive pre admission assessment and the care plans includes interventions required to meet residents needs. Faulty equipment and furnishings have been replaced. The home has a friendly relaxed environment which relatives confirmed. Financial interests are safeguarded. The home does not manage accounts for residents. It may hold small allowances for residents and these are receipted and stored securely. Staff receive mandatory training and systems and equipment is tested. The refurbishment is ongoing and as such not all areas of the home are safe as yet. Staff supervise residents to ensure safety. Quality assurance forms are sent to relatives to elicit feedback and an AQAA was completed for the Commission. Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 23 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no 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 OP12 Regulation 16(m) Requirement The routines of daily living and activities made available are flexible and varied to suit service users’ expectations, preferences and capacities The registered person conducts the home so as to maximise service users’ capacity to exercise personal autonomy and choice. Timescale for action 31/10/07 2 OP14 12(2)(3) 31/10/07 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 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Ashdown Nursing Home DS0000062422.V348970.R01.S.doc Version 5.2 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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