Random inspection report
Care homes for older people
Name: Address: Asheborough House Asheborough House St Stephens Saltash Cornwall PL12 4AP one star adequate service 25/08/2009 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: Gail Richardson Date: 2 3 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Asheborough House Asheborough House St Stephens Saltash Cornwall PL12 4AP 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sheval Limited care home 31 Number of places (if applicable): Under 65 Over 65 0 0 31 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 31 31 0 The maximum number of service users who can be accommodated is 31. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Mental disorder, excluding learning disability or dementia (Code MD) Date of last inspection Brief description of the care home Asheborough House (previously called Beech House) is a detached property set in its own grounds with a lawned area to the side and rear. Car parking is available in the
Care Homes for Older People Page 2 of 11 0 5 0 2 2 0 1 0 Brief description of the care home grounds of the home. Saltash is approximately five minutes away by car and has all the usual facilities of a small town. Accommodation and care to include nursing is offered at the home in the category of dementia or mental disorder. The home is entered via secured garden gates into an entrance with communal areas off to include a lounge and a dining room. A shaft lift is available to all the bedrooms in the home on the first and second floor. The laundry and kitchen are on the lower ground floor area of the home. Fees range from £550.00 to £700.00 per week (Fees correct as to the time of this report ). An additional charge is made for dry cleaning, visits from a hairdresser and chiropody. The Statement of Purpose and Service User Guide (available in an easy read format) are available on request. Care Homes for Older People Page 3 of 11 What we found:
This random inspection was carried out by Regulatory Inspector Gail Richardson over a 3 hour period on the 23rd March 2010. The purpose of the inspection was to look at the requirements made at the previous key inspection on the 25th August 2009 and random inspections on the 4th December 2009 and 4th February 2010 which had highlighted shortfalls in some areas. For the purpose of this report the term we will be used when referring to the Care Quality Commission. We met previously with the Manager Designate , Responsible Individual and one of the Directors of the service on 23rd February 2010 to discuss the random inspection undertaken on the 5th February 2010 and agree actions to be taken to address areas of concern. This inspection was undertaken to look at the monitoring of people nursed in bed, activity provision, staff recruitment to meet the skill mix needed, staff training and Regulation 26 visits and reports. On arrival at the service no person was being nursed in bed and so this requirement could not be assessed. At the time of this visit there were 28 people living at the home. During the morning there were on duty, the manager designate, 11 care assistants, one cook, one kitchen assistant, one laundry staff and one cleaner. Of the 11 care staff this included one new staff undertaking induction, one Registered Nurse undertaking induction and two staff from another home in the company group. As part of this inspection we spoke with 6 staff members and two people using the service. What the care home does well:
We were advised that staff had been recruited by the manager designate and that the shortfalls seen previously were being addressed. We will review recruitment at the next key inspection. The manager designate demonstrated that all new staff undertake an induction process. The induction is in line with the Skills for Care, Common Induction Standards. We spoke with senior staff who include induction as part of their role and they described how the induction process was undertaken to support safe practice and support people using the service. We are advised that 8 new staff have been recruited of which over half have a National Vocational Qualification. Staff from other homes in the group who work at the home on some occasions have now received the training they needed in moving and handling to ensure that people using the services and staff are safe. Qualified staff who have been employed at the home recently told us that they were undertaking an induction process which was staged to support safe practice. The manager designate now includes the actual hours worked on the staff rota to ensure that there is a clear audit trail of hours worked is available. Care Homes for Older People Page 4 of 11 The management of the home have recruited further qualified staff to support a better skill mix of staff to include both Registered Mental Nurses and Registered General Nurses. The registration of the home is both for nursing care and dementia care and a sufficient skill mix is important to ensure that all the identified care needs can be sufficiently met. We saw that newly qualified staff were being supported to undertake this new role and that more experienced staff are working with them to support them through the induction. A staff training plan has been implemented to ensure that staff training in all mandatory areas is being planned and provided. Staff told us that they had been receiving training recently and that moving and handling and infection control training had recently been made available. We looked at the training plan and could see that further training is planned. We will review this further at the next key inspection to ensure that all staff have received the mandatory training needed. What they could do better:
At the previous key inspection we made a requirement that The registered person is required to develop a programme of meaningful activity for each person. This activity should be recorded to further develop activity to support peoples choices and preferences. The manager designate confirmed that at this time, that this is not taking place. This is due in part to the current building of the staff team following recruitment. The manager designate hopes that with the progression of a stable staff team that an activity coordinator can be sourced to provide a designated role for activities to enable the development of social and recreational activities for people using the service. Staff told us that activities are undertaken when there is free time to do so. We observed that staff were spending time interacting with people whilst tasks were being performed. There appeared to be no designated social time or activities taking place. In the main lounge the TV was playing but people did not appear to take any interest in this.There was a visit to the home by the Pat dog and people using the service appeared to enjoy this, but no other activities were seen to take place at this time. We looked at the staff rota and cannot identify who takes clinical responsibility for nursing care on a day to day basis. We have agreed a timescale for response to this issue with the responsible individual which has not yet been exceeded. We would required that due to pending changes in management this role be defined with the Commission to ensure the clarification of clinical responsibility . At the previous random inspection we required that The responsible person must forward all Regulation 26 monitoring visit reports to the lead inspector. This is required to ensure that we can continue to monitor closely the development of the service. At this time we have not received any regulation 26 reports from the Responsible Individual. We have made one further request by telephone and the report for February 2010 has not yet been received. We talked to staff about training and they told us that some mandatory training has been made available. Abuse awareness training has now been booked for the following week and we will review this at the next key inspection. Care Homes for Older People Page 5 of 11 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 6 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 8 12 The registered person must 24/09/2009 ensure that monitoring and a record of this monitoring is undertaken for people who are nursed in bed and do not have access to summon assistance. This will ensure that people have access to staff when needed. 2 12 16 (2)(m) People must be able 31/01/2009 to engage in local, social and community activities, within their capabilities, and as they wish. Arrangements for this should be part of care planning. So people can live a fulfilled life and are not socially isolated. 3 12 16 The registered person is required to develop a programme of meaningful activity for each person. This actvity should be recorded to further develop activity to support people choices and preferences. 30/09/2009 4 18 12 The registered person must ensure that all staff have received training in abuse 30/10/2009 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 awareness. This is required to ensure the protection of people using the service. 5 29 19 The registered person must 30/10/2009 ensure that all staff have recruitment checks in place which include two references, this is to include one from the most recent employer or the reason why this is not possible. This is required to ensure the protection of people using the service 6 29 19 The Registered Person must ensure that all appropriate recruitment checks are in place prior to people commencing employment at the service. This must include a full employment history and appropriate police checks. This is to ensure that people using the service are not at risk of harm. 7 30 18 (1)(c) Staff must be trained and competent in all conditions which affect people at the home, especially dementia. So that people receive appropriate and effective care. 8 38 26 The responsible person must 26/02/2010
Page 8 of 11 02/03/2010 31/03/2009 Care Homes for Older People 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 forward all Regulation 26 monitoring visit reports to the lead inspector. This is required to ensure that we can continue to monitor closely the development of the service. 9 38 18 The registered person must 19/03/2010 ensure that all staff have the skills both individually and collectively to provide the care to meet peoples needs.This is with reference to moving and handling training. This is required to ensure that staff and people using the service are not placed at risk of injury. 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
