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Inspection on 22/04/10 for Ashdown Nursing Home

Also see our care home review for Ashdown Nursing Home for more information

This inspection was carried out on 22nd April 2010.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Not applicable to our visit.

What the care home could do better:

Statutory Notices have not been complied with.

Random inspection report Care homes for older people Name: Address: Ashdown Nursing Home 2 Shakespeare Road Worthing West Sussex BN11 4AN two star good service 02/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Ann Peace Date: 2 2 0 4 2 0 1 0 Information about the care home Name of care home: Address: Ashdown Nursing Home 2 Shakespeare Road Worthing West Sussex BN11 4AN 01903211846 01903208680 mgnewcare@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Newcare Homes Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 40 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 40 40 The maximum number of service users to be accommodated is 40. 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) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home 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. Care Homes for Older People Page 2 of 11 0 2 0 7 2 0 0 9 Brief description of the care home The registered manager was Mrs Susan Green but we have been informed that Mrs Green has resigned. Ashdown Nursing Home is registered for 40 residents over the age of 65 years who have dementia. The 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 600 to 700 pounds per week. Care Homes for Older People Page 3 of 11 What we found: Following on from a Key unannounced inspection carried out on 22 February 2010 the Quality Rating for this home was deemed as 0 stars (POOR) and Statutory Notices were issued for failing to comply with regulations. Although page one of this report indicates a good service this now reverts to a POOR service, the template for the report was unable to be changed because the inspection report from the inspection on 22 February 2010 was not made final until after CQCs visit on 22 April 2010. We visited Ashdown Nursing Home to follow up on Statutory Notices that were served on the home on 18th March 2010. The Notices related to a breaches in the following regulations: Regulations 13 (4)(a),(c). The registered person shall make suitable arrangements to prevent infection, toxic conditions and spread of infection at the care home. Regulation18 (1)(c). Ensure that the persons employed by the registered person to work at the care home receive - (i) training appropriate to the work they are to perform including structured induction training. Regulation 23 Fitness of premises. There are provided at appropriate places in the premises sufficient number of lavatories, and of wash basins, baths and showers fitted with hot and cold water supply. Regulation 26 Visit by registered provider. We found only one of the Statutory Requirement Notices - Regulation 26 to have been complied with. The training of all staff in manual handling had not been completed by 17th April 2010, despite an action plan from Mr Beeharee dated 14th April 2010 stating that all staff who needed manual handling updates had received them. During our visit we noted that some staff had received training in manual handling but there were a number who had not. We did see that training has been arranged for the remaining staff on 4th May 2010. They have failed to comply with the Statutory Notice. During our visit we found that the hot water supply in hand wash basins and baths was insufficient so had not been complied with by 17th April 2010. Mr Beeharee had stated in his action plan dated 14th April 2010 that there was only one room where the hot water flow was deficient and all other taps in the home have an effective hot water supply. This was not the evidence we found during our visit. They have failed to comply with the Statutory Notice. Mr Beeharee did e-mail CQC the day following our visit to say the plumber had been into the home and had fixed the hot water system and that all hot water outlets had an effective flow. Care Homes for Older People Page 4 of 11 The Statutory Requirement is now met. The action plan from Mr Beeharee stated that all staff would have infection control training by 22nd April 2010, and that there would be suitable systems in place to ensure safe infection control procedures were in place there was no evidence that this had happened. They have failed to comply with the Statutory Notice. Although improvements have been made, the home was cleaner, there was new bathroom equipment and in some bedrooms new furniture, however there were still bedrooms with offensive odours in them. We believed there was a failure to comply with a condition or regulations imposed by or under Part 11 of the Care Standards Act 2000. Therefore we served a Code B notice on the service which was accepted by Mr Beeharee. A Code B Notice is issued in accordance with paragraph 6.7 of the Code B of the Police and Criminal Evidence Act 1984. Code of Practice for the searching of premises and the seizure of property found on persons or premises. Mr Beeharee informed us that Mrs Green had resigned as Registered Manager and has left the home. Mr Beeharee told us until a suitable manager was found he would be acting manager. We did tell Mr Beeharee that CQC were very concerned about the poor management of the home. Despite Mr Beeharee and the deputy manager being in the home almost on a daily basis and the deputy manager working directly with service users they had not noticed the deterioration of the home and intervened before the situation became as serious as it did. Following on from a Key unannounced inspection carried out on 22 February 2010 the Quality Rating for the home was deemed as 0 stars (POOR) and Statutory Notices were issued for failing to comply with regulations. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 15.1 and 2.The registered manager must ensure that there are clear and current care plans in place that are regularly updated This is to ensure that people are receiving the care and support they need at all times. 17/04/2010 2 8 12 12. 1 and 3. The registered 17/04/2010 manager must ensure that the use of pressure relieving equipment is clearly documented and regularly reviewed This is to ensure that people are not put at risk by incorrect pressure care being provided. 3 12 16 16.2 (m) The registered manager must ensure that the programme of activities on offer meets the needs of people with dementia This is because although there is a programme of activities in place it does not meet the needs of all of the people in the home. 17/04/2010 4 15 16 16.2 (i) The registered manager must ensure that 17/04/2010 Care Homes for Older People Page 6 of 11 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action advice is gained from a nutritional expert. This is to ensure that the home provides good quality nutrition that is suitable for all service users. 5 15 16 16.2 (1) The home must provide nutritious food at regular intervals of no more that 12 hours between supper and breakfast This is because at the visit we found that some people were not having nutrition for 17 hours between the evening meal and breakfast. 6 18 13 13.6 The registered manager 17/04/2010 must ensure that the staff team have a working knowledge of how to protect people from risk of abuse or harm. This is to ensure that there is an awareness of all forms of abuse and how to identify and report them. 7 24 13 13.4 (a) to (c)The registered 17/04/2010 manager must ensure that all furniture is safe for use and that people have clean and good quality bedding. This is because there were ripped armchairs and dirty bedding that was in a poor and threadbare condition in use in the home. 11/03/2010 Care Homes for Older People Page 7 of 11 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 8 26 13 13. (3) The registered 17/04/2010 manager must ensure that infection control best practice is followed and that the staff team all receive training. This is because a number of infection control issues were identified during the visit, putting service users at risk. 9 30 18 18. 1 (a) to (c)The registered 17/04/2010 manager must ensure that training for staff is provided and is kept up to date This is to ensure that people are being supported by a well trained and competent staff team 10 33 24 24. 1 to 3 There must be a 17/04/2010 quality assurance system carried out on a regular basis at least annually. This is to ensure that the views of service users, families and other people involved with the home are heard. 11 36 18 18. 1 and 2 The registered 17/04/2010 manager must ensure that the staff team receive supervision and appraisal on a regular basis. This is to ensure that the staff team are supported and their practice monitored 12 38 23 23. 1 and 2 The registered manager must ensure that 17/04/2010 Care Homes for Older People Page 8 of 11 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action all health and safety issues are addressed and that includes risk assessments for unguarded stairs and safety of the environment This is to ensure that service users are kept safe and that there are processes in place to monitor their care and safety at all times. Care Homes for Older People Page 9 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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