Inspection on 05/10/05 for Ashdowne Care Centre

This inspection was carried out on 5th October 2005.

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

Ashdowne Care Centre 24/09/07

Ashdowne Care Centre 12/07/06

Ashdowne Care Centre 19/05/05

Ashdowne Care Centre 14/10/04

Ashdowne Care Centre 10/06/04

Ashdowne Care Centre 22/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Ashdowne Care Centre Ashdowne House & Pinnex Moor Orkney Mews Pinnex Moor Road Tiverton Devon EX16 6SJ Lead Inspector Rachel Doyle Unannounced Inspection 5th October 2005 11.30a 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 Ashdowne Care Centre DS0000026697.V250593.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. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashdowne Care Centre Address Ashdowne House & Pinnex Moor Orkney Mews Pinnex Moor Road Tiverton Devon EX16 6SJ 01884 252527 01884 242194 ashdownecare@onetel.com 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) Ashdown Care Limited Mrs Alison Southcott Care Home 60 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (34), Old age, not falling within any other category (34) Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registered for 34 - Elderly General Nursing Care Registered for 34 - Elderly Mental Health Care The Home may from time to time admit up to three persons between the ages of 55 and 65 years of age. 19th May 2005 Date of last inspection Brief Description of the Service: Ashdowne is a purpose built nursing home, which opened in 1993. The present owner acquired the property in 2001. It comprises two units under one registration. The units have been linked by an enclosed corridor but continue to accommodate service users with distinct types of nursing needs in each separate unit. Pinnex accommodates 26 service users who are elderly with mental health needs. Ashdowne accommodates 34 elderly persons requiring general nursing care. The Home is managed as a whole by the registered manager, Alison Southcott. The Home does not offer intermediate care but makes provision for respite and convalescence care on Ashdowne. The sides and back of the property are garden areas and the front is a car parking area with a porta-cabin used for administration, training and meetings. The home is situated in a residential area of Tiverton. The kitchen is housed in Ashdowne and the laundry in Pinnex. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Wednesday 5th October from 11.3015.30. Three inspectors carried out the inspection, one to inspect core documents and one on each unit. The manager was available to discuss issues with the inspectors and staff, especially the covering administrator, were very helpful throughout the inspection. Relevant documents and records were made available and the inspectors were able to move freely about the Home. On Ashdowne unit one inspector spoke to the manager, administrator/home services, senior activity organiser and 3 residents in depth. At the time of the inspection the Home was almost full to capacity. Residents were preparing for lunch in various communal areas and some residents were relaxing in their rooms. It was a sunny day but fresh and the Home felt warm and comfortable. One inspector spent the whole inspection on Ashdowne. They spoke privately with 6 residents, four of who showed a degree of disorientation, with 2 of the carers, one of the Registered Nurses and one of the activity co-ordinators. The inspector sat observing lunch in the upstairs red lounge where 7 residents ate, all of whom needed a degree of assistance to eat. What the service does well: What has improved since the last inspection? What they could do better: Overall consistency, maintenance and monitoring. Plans for garden and consultation with residents/reps. English language and use of agency and monitoring Radiator risk assessments and consultation with Health and Safety. Recruitment documentation. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 6 Appropriate ventilation in one room. Care plan recording of details not staff local knowledge and resident/representative involvement in the care planning process. Activity records for individuals, especially those with limited communication/engagement, all residents to be included or have tailor made options, carer involvement. Spiritual needs recording and discussion. QA system does not go far enough to address any comments and record who returned cards, not detailed enough. 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. Ashdowne Care Centre DS0000026697.V250593.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 Ashdowne Care Centre DS0000026697.V250593.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): This was not judged. EVIDENCE: The Home does not offer intermediate care at present. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10, 11 Residents’ health and personal care are met but improvement is needed in the care planning process to ensure that staff and residents are fully aware of how their needs are met. EVIDENCE: Ashdowne- Four care plans were looked at. Care plans were generally good, well presented and easy to use. However there was a lack of detail, sometimes relating to primary issues, which affected activities of daily living such as communication needs, partial sight, nutrition linked to elimination problems etc and identified actions relating to these. There was no evidence of resident or representative involvement except one case-tracked whose relative wanted involvement but records did not support that this had happened at all. There were signs to remind staff to ensure that residents had access to drinks ion the hot weather and all residents were seen to have drinks. There were good pressure area risk assessments and the recorded equipment was seen to be used in practice. Pad use information was discreetly given. There was good liaison with health care professionals but actions and reasons for visits were not always recorded. Diabetic check-lists were excellent. The Home keeps a check on residents’ regular dentist, optician and health checks. NHS and private chiropodists are used as residents wish. Information around terminal Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 10 and spiritual care and arrangements after death was inconsistent. Staff were seen to be knocking on doors before entering and residents said that they were treated with respect. There is a pay phone for residents who can also ask to use a phone in private or have one fitted in their rooms. Staff were seen to assist with feeding sensitively. One resident said that staff take them for a walk regularly, others spoken with were either unable to say or unable to walk. Five of six residents spoken with confirmed that they find that staff are friendly and polite (see NMS 18), one resident said staff are “very caring”. Pinnex Moor - Staff said that as part of the activities programme gentle exercise was sometimes offered but not on a regular basis. They explained that a goal was to keep residents’ mobile and that this was encouraged. It was noted that the residents in the upper lounge were quite sedentary and one person was encouraged to sit down when they moved around the room. However, in the lower lounge, which is larger, residents moved around more with some people walking up and down the corridor. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 Social activity arrangements have improved and provide daily stimulation for most residents, however all residents must be included especially those who have difficulty communicating. EVIDENCE: Ashdowne- The activity organiser was able to describe various activities, which had taken place recently including a successful fundraising cream tea for residents and relatives/visitors. The staff member said that a training day focussing on activities suitable for those living with dementia had been inspiring and they were able to discuss how this may be put into practice at the Home. The manager was very knowledgeable about the needs and social histories of residents and knew their preferred choices. These were no always recorded for all residents but some had been addressed ie activity preferences for some and meal likes. Some notes did have excellent detail such as ‘doesn’t like talc’, ‘prefers no dentures’ but this was not consistent. Residents spoken with on Ashdowne mentioned doing some craft work, one person said they had enjoyed playing the tambourine to music recently and another said they had been on one outing to the coast during the summer. The person who had been on the outing said they had enjoyed it and would like more opportunity to go out on trips; people who could communicate indicated Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 12 that they were happy with the level of activity available. The two carers spoken with said that they have time to spend chatting with residents and sometimes do individual pampering (e.g. applying nail polish) in the afternoons. Two activities staff are employed for 40 hours per week to cover both parts of the home. Throughout the inspection staff were seen addressing residents politely and gaining permission before they assisted with personal care. One inspector sat in a dining room during lunch; of the seven residents in the room six sat in armchairs and needed assistance to eat and all clearly had limited ability to communicate verbally. Care staff provided appropriate help and on all but one occasion told residents what food was on offer- giving choice where residents were able to indicate a preference. Staff sat with individual residents giving them time to eat and chatted in a manner that tried to include residents even though they were mostly unable to fully participate themselves. Soft diets were individually presented and one person was equipped with a plate guard, which helped them to eat more independently. Pinnex Moor – in the upper lounge the television was on at the start of the inspection. Nobody appeared to be actively watching it and it was later switched off and music put on. Several people were sitting at the table and other people in armchairs. There were no books, newspapers or anything to look at i.e. a rummage box or photographs. However, an activity session was in progress in the lower lounge and the member of staff interacted well with residents, giving them choice about joining in and the level that they wanted to participate at. Discussion took place around recent specialist training in this area and the positive outcomes in terms of ideas and understanding of the needs/abilities of the residents. There appears to be a lack of clarity around the funding of activities and the manager said that she would ensure that staff were aware that there was not a fixed monthly amount. Records are kept of activities but they do not show if residents have been encouraged to participate but have chosen not to. For example, a resident who had lived at the home for several months had no record of involvement in any form of activity. Care staff on Pinnex Moor spoke about the positive impact of activities for residents. A meal was briefly observed in the lower lounge. Carers sat beside people while they assisted them with eating their meal. They told people what the food was and gave choice about the quantity. Most people were sitting at the tables. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Residents are now confident that they are listened to and there is an improved complaints process. Arrangements for protecting residents are not fully satisfactory. EVIDENCE: There is now a comprehensive complaints book and staff and management have been keeping a good record of all complaints/concerns including the actions taken and outcomes. Residents said that they felt that they were listened to. One resident told an inspector that staff mistreated them but would not discuss this further; the manager said that this was a regular allegation sometimes made in circumstances that could not be true e.g. saying a certain person had hurt them when that person had not been working at the time. It appeared that on this basis none of the residents allegations were therefore believed or investigated, there was no reference to her regular allegations in her care plan or daily diary nor had a multi-disciplinary discussion taken place to ensure that the resident is properly protected and staff know how to respond so that allegations are not automatically dismissed. Pinnex Moor – Complaints and concerns are now recorded with outcomes. A summary of complaints and their outcomes must be provided to CSCI by May 2006. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25 The choice of inappropriate door locks does not benefit residents living at Pinnex Moor. Internal improvements to the décor have been made on both units and external improvements are ongoing to ensure that residents are provided with safe, comfortable surroundings although there is an issue with ventilation in one room. EVIDENCE: There is a new maintenance man who works part-time. He is very busy and there are lots of jobs for him to do. One resident spoken with was disappointed by the fact that they had been waiting 10 months for the home handy man to put up a shelf for them The Home were aware of any issues which the inspectors raised. All areas seen were clean and properly maintained. Rooms throughout the Home were personalised. However, one room has no means of ventilating the room without opening the patio door as there is no window. This needs to be addressed. All residents asked said that the home is kept clean. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 15 Pinnex Moor – the lower bathroom’s appearance has improved since redecoration. Rooms seen were clean and odour free. On the last inspection, all rooms had radiator guards to protect residents from harm. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Residents generally benefit from trained, friendly staff in adequate numbers on both units. The home does not ensure that all staff have the language ability to mentally stimulate residents and describe their role. EVIDENCE: Six recruitment files were looked at. Three files contained the correct information but the other three had various gaps in documentation such as clear employment history, lack of references, photographic identification and one file had no CRB returned as yet. This staff member must not work unsupervised until this or at least a POVA First check has been satisfactorily obtained. Some information received by the Home from CRBs or references had been followed up in supervision sessions. There was also good discussion with a possible new staff member regarding CRB checks. The disposal of CRB forms after the inspector has seen them was discussed. Training files were looked at and were up to date. There has been minimal training over the summer but the Home continue to follow a programme of training in dementia care starting again soon. Ashdowne- Residents said that that staff are available to give them help when they need it and that they do not have to wait to long. They confirmed that staff do not rush them. Staff said that they think there are generally enough of Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 17 them on duty to provide care to residents in an unrushed way and that they usually get time in the afternoon to spend talking with residents. The registered nurse who spoke with the inspector said that they had recently received training about caring for people with Dementia which she said was very useful and well presented, she had also attended sessions about Huntingdon’s Chorea and a session run by a hospice nurse as well as a variety of other sessions. Both the carers who spoke with the inspector had attended training about caring for people with Dementia which they said covered issues such as communication and seeing things from the perspective of people with Dementia, they too had attended other training in recent months; they confirmed that they are paid to attend most training. One of the two carers said they were starting work towards their NVQ 2. Overseas staff on Ashdowne were able to communicate with residents fairly clearly in English. The inspector spoke with one member of the over-seas staff, this person was able to understand and express herself clearly in English. Pinnex Moor – Five members of care staff were spoken to individually, one person felt quite pressurised by work but the general agreement that staffing levels of four carers in the morning and afternoon, plus a nurse as senior benefited residents as they could spend more time with them. This was reflected in the staff rota. Carers spoke about working as a team and that there was a more relaxed atmosphere with continuity in the staff group. However, serious concern has been raised with the manager over the fact that not all carers were able to communicate well in English, which meant that they were not able to describe the care they provided or the needs of the residents. The staff-training file for one person showed no assessment of their training needs, despite their obvious difficulty with the English language, which they themselves acknowledged. This was observed in a discussion and through over heard conversations. No pro-active steps had been taken by the home to address the situation. Independently, staff have enrolled at English classes at a local college. A number of staff spoke positively about the impact that dementia awareness training had made on the way they practiced. They could give individual examples and could ‘put themselves in the residents’ shoes’, which they felt was a valuable lesson. Care staff spoke positively about the training schedule for the next few months, which was on display in the office. This included further dementia awareness training. Ashdowne Care Centre DS0000026697.V250593.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, 38 The management structure at the Home provides clear lines of accountability and staff support. The health and safety and welfare of residents is not always protected by the systems in place. Little progress has been made on making the Pinnex Moor garden a safe and stimulating environment for residents. EVIDENCE: The Home manager works closely with a senior post on each unit. She achieved her Registered Managers’ Award in February 2004. She is an RGN and has Palliative Care experience. A Home Services manager oversees the running of the kitchen, laundry and domestic service for 20 hours a week. Alison said that the owner, who lives out of area, would take time to discuss issues as they arrive and will stay overnight in Devon as necessary. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 19 The fire equipment was up to date with checks and just due. Radiators are covered in residents’ rooms but not in corridors or bathrooms, which have top shelves only. The manager said that this had been agreed with Health and Safety as acceptable. A copy of this agreement should be sent to CSCI. They are about to be run on a thermostat. Individual slings for manual handling equipment were seen. Automatic door closers are being ordered over time to allow residents to keep their doors open safely. Wooden wedges weren’t seen being used but should be removed from rooms. The Home did a quality assurance residents’ satisfactory survey in April/May 2005. 38 comment cards were returned. Although results were collated these were not in enough detail to clearly outline the action taken relating to comments or how many residents or relatives replied. One resident wanted more activities but this had not been followed up. None of the residents spoken with could recall being asked what they think about the service they receive or if they had any ideas about how it could be improved. The personal allowances for three residents were spot-checked. One account was a £1 out but the other two accounts balanced. Receipts are kept, which were cross-referenced with bills, and deposits and withdrawals signed out by one member of staff. Pinnex Moor - Staff and the manager confirmed that work had started on the garden at Pinnex Moor a week before the inspection. This is outside of the requirement timescale made on the last inspection. Progress is poor with trip hazards still in place, uneven pathways and a lack of level access. A straight path has begun to be laid but concern was expressed that this was too narrow for a carer to walk alongside a resident. No specialist guidance has been sought regarding the layout of the garden to ensure that it provides a stimulating and relaxing, safe environment for residents. Staff and residents spoken to during the inspection said they have not been consulted to suggest ideas for the garden. Two residents’ files were looked at and these contained assessments for the use of bed rails. A senior said that she advised staff about checking they were positioned safely but a record was not kept. The manager explained that this was one of the duties of the maintenance man and that rails were numbered in a record book, this was not seen. Ashdowne Care Centre DS0000026697.V250593.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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 1 Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 21 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 OP18 Regulation 13 (6) Timescale for action The registered person shall make 30/11/05 arrangements, by training staff or by other measures, to prevent residents being harmed or being placed at risk of harm or abuse. This refers to protection of a particular resident, which was discussed with the manager and a letter also sent requesting an individual action plan and multidisciplinary involvement. The registered person shall not 30/11/05 employ a person to work at the Home unless they have obtained in respect of that person information and documents specified in Schedule 2, para 17. Any staff without satisfactory CRB must not work unsupervised. Requirement 2 OP29 19 Schedule 2 Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 22 3 OP30 18 (1) (a) 4 OP38 13(4) (a) The registered person shall, 31/12/05 having regard to the size of the care home, … and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. (All care staff must be able to speak a standard of English that enables them to communicate and understand residents, staff and explain their role). This issue has been raised on a previous inspection. You shall ensure that all parts of 31/12/05 the home to which the residents have access are so far as reasonably practicable free from hazards to their safety. This refers to the current standard of garden maintenance on Pinnex Moor. (This is an outstanding requirement). 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 Good Practice Recommendations DS0000026697.V250593.R01.S.doc Version 5.0 Page 23 Ashdowne Care Centre 1 2 3 4 Standard OP7 OP8 OP11 OP12 5 OP16 6 OP19 7 OP25 8 9 OP24 OP33 Care plans should clearly state how needs are to be met and residents/relatives should be offered involvement in the care planning process. Residents should have the opportunity of regular physical exercise. For example, armchair exercises. Residents’ wishes concerning terminal care and arrangements after death should be discussed and recorded and carried out. Activity records should show if residents have been encouraged to participate but have chosen not to and all residents, regardless of capacity, should be given opportunities for stimulation and recreational activities in and outside the Home. Social history records and preferences should be obtained for all residents and recorded. The home should supply the CSCI with a statement containing a summary of the complaints made during the preceding twelve months and the action taken in response. The garden should be designed to stimulate residents with dementia i.e. through smell, colours, a choice of places to sit and a circular path to encourage physical activity. This may mean seeking expert advice, visiting homes with well designed gardens or looking at research in this area of design. It is recommended that appropriate ventilation be provided in one particular resident’s room and/or that a discussion about the ventilation currently provided be included within the new resident assessments when admitting to this room. Locks on residents’ rooms should be appropriate to the client group living at Pinnex Moor. Quality Assurance survey results should be collated in enough detail to clearly outline the action taken relating to comments or how many residents or relatives replied. Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. Extracts may not be used or reproduced without the express permission of CSCI Ashdowne Care Centre DS0000026697.V250593.R01.S.doc Version 5.0 Page 25 - 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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