Inspection on 02/08/06 for Asher House

This inspection was carried out on 2nd August 2006.

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

Asher House 08/07/08

Asher House 05/07/07

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

CARE HOMES FOR OLDER PEOPLE Asher House Third Avenue Walton on Naze Essex CO14 8JU Lead Inspector Lysette Butler Final Unannounced Inspection 09:00 2nd August 2006 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 Asher House DS0000066638.V306983.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. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Asher House Address Third Avenue Walton on Naze Essex CO14 8JU 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) 01323 646548 Sentimental Care Asher Limited Mrs Vera Francis Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 20 persons) 13th December 2006 Date of last inspection Brief Description of the Service: Asher House is a large detached property situated in a residential area of Walton on the Naze. The home is within walking distance of the seafront and local amenities. Asher House has well maintained gardens to the rear of the building, which are only accessible to people living at the home. It also has a small garden to the front of the building that can be viewed from a number of the service users rooms. Asher House is registered for older persons who need care by reason of a physical disability. Although there is one resident with a mental illness, the home is not registered to admit any other person in this registration group. Asher House has 12 single rooms of which seven are en-suite and four double rooms of which are none are en-suite. Current fees are between £367 and £420. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection started on 1st April 2006. The inspection process included: a site visit on 2nd August 2006, which lasted 7 hours; review of evidence supplied by the proprietor, residents, visitors to the service and the staff; resident, visitor, healthcare professionals and staff surveys; discussions with the registered manager, her deputy, senior carers, care staff, ancillary staff, residents and relatives/visitors. During the site visit the premises were inspected, including inspection of the grounds. Samples of records and residents care plans were also reviewed. The home was clean and well maintained. The overall care and well being of the residents was the focus of the inspection. Staff and residents were welcoming and happy to speak to the inspector at the site visit. This inspection covered all twenty-three key standards and one of the remaining standards. The manager and her staff approached the inspection in a positive and cooperative manner that was focused on achieving best practice to meet the needs of the residents. What the service does well: What has improved since the last inspection? Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 6 Ongoing refurbishment of the home is continuously improving the environment for the residents and garden had been well used this summer due to the warm weather. The supervision had been commenced since the last inspection and all appraisals were up-to-date. 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. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 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 Asher House DS0000066638.V306983.R01.S.doc Version 5.2 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): 3 & 6 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Prospective residents and their families are given both written and verbal information that allows them to make an informed decision as to whether Asher House is the right place for them to reside. EVIDENCE: An up-to-date statement of purpose was supplied to the inspector during the site visit. The new document contains details of the new owners and all other elements required for this document. The manager and deputy manager were looking at combining the preassessment and admission documentation for prospective new residents, into one document. This is to reduce the amount of double documentation that is currently being undertaken. Combining the documents would also allow the admitting carer more time to spend talking to the new resident and individualising their admission procedure. The current assessment Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 9 documentation is good and links well with the initial admission assessment. The registered manager or her deputy undertakes all pre-assessments. Although the deputy is still being trained and discusses every potential new resident with the registered manager before a place is offered. Intermediate care beds are not offered at this home. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Health and personal care at this home is highly individualised and staff demonstrated a good relationship with other professionals allied to health, ensuring that residents remain as healthy as possible. EVIDENCE: Three resident care plans were review during the site visit. There has been no change to the layout of the care plans since the last inspection. The content and detail remains good. Care staff demonstrate a commitment to the documentation of care. As well as the care plan there are separate folders for the daily records and admission to hospital details, so that the basic information needed for admission is available to be picked up quickly and given to paramedics if needed. All plans were reviewed monthly and weekly key worker reports. Neither the resident nor their relatives had signed any of the three files reviewed. Health care is good throughout the home. The staff reported that they had a good relationship with the local district nurses and files reviewed demonstrated Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 11 evidence of residents having access to optical, dental and chiropody care. All residents were registered with a local GP of their choice and GPs visited the home on request. This home use a mobile pharmacy service that collect the prescriptions, fill them and deliver medications to the home directly. The registered manager and staff are happy with the contract and the firm themselves ring the home regularly to check that everything is in order. The pharmacy service recently carried out an audit at the home that did not highlight any problems. The staff use a separate trolley for medications that need returning, or for extra medication, as at the beginning of a new month they cannot fit all medications into the trolley that is used everyday. The firm collect returns monthly. The staff that administer medications follow the homes policies and procedures well. During the site visit all medication administration records were checked and were found to be correct. The home does not presently contain a controlled drugs cupboard. The registered manager is aware of the appropriate requirements, but none of the current residents need any controlled drugs. The inspector advised the registered manager to have a controlled drugs cupboard fitted as soon as possible, however the inspector is also aware that their medications room and the fitting of a new controlled drugs cupboard was on the refurbishment plan currently being compiled. The general atmosphere in the home was very good staff and residents were observed getting on well and the residents privacy and dignity being observed at all times. Residents spoken to felt very safe at the home and found the staff to be very kind and helpful. One of the most recent resident admissions to the home told the inspector that staff never entered their room without knocking and did not sit down to chat unless asked. The same resident talked to the inspector about a friend they had left behind in their last place of residence and how the staff helped them to maintain contact. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Daily life and social activities in this home ensure that residents are enabled to do with as much or as little as they wish with the help of the staff. EVIDENCE: Activities in this home are discussed and chosen by the residents. There are a number of games available and staff spend time with the residents chatting most days. A timetable of all outside entertainment was evident throughout the home, this included entertainers coming into the home and the staff taking residents out on trips. The week previous to the site visit the registered manager had arranged to take all residents down to the beach for a picnic and close to the home for a few hours. The residents spoken to stated that they had really enjoyed the trip and that staff made it a really memorable day. Also 10 residents had recently gone on a coach trip to Silver End and other trips were playing further the remaining summer months. There is also planned an ‘East End’ night during September, where the staff are all going to dress up and the cook is going to serve an ‘East End’ type menu including jellied eels. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 13 A yearly fete is arranged at the home, for the residents, their visitors and the local community, the money raised goes towards further activities for the residents. This home does not have an activities coordinator it is part of the registered managers job and appears to work well within this environment. The registered manager talks to the neighbours about changes the home wishes to make and keeps them informed of activities within the home. A new estate of houses have been built right next door to the home and are very close to the perimeter fence, because of this the manager has been in to look at the houses at various times and has kept in contact with the builders to ensure that residents privacy will be maintained once the new houses are occupied. All residents who were in the home on 31/10/05 were on the electoral register; new residents will be added in the return for October 2006. There were no volunteers at this home at the time of this inspection. Food offered at this home was varied, appetising, balanced and served in appropriate quantities. The residents and their visitors spoken to at the time of the site visit said that they enjoyed the food and it was, of a very high standard. One resident told the inspector that they had put weight on since coming into the home, because the food was so good. (Previous to their admission to this home they had been losing weight.) During both breakfast and lunch, staff were observed sitting and helping residents with a feeding in an entirely appropriate manner. Residents spoken to said that they could choose where to eat their meals, whether this was in their room, outside in the sunshine, or in the dining area. The residents spoken to during the site visit all said it was up to them when they had their meals and where they had them. The full-time cook works Monday to Friday and there is a regular weekend cook, who also fills in during the full-time cooks leave. Residents stated that it did not matter which of them was cooking the food was always good. There had been a recent EHO visit, but the registered manager had not displayed the certificates supplied as she was in discussion with the officer about some of the issues raised. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Policies & procedures in this home ensure the safety of the residents and staff are aware of their responsibilities under Protection of Vulnerable Adults policies. EVIDENCE: No complaints had been received by the home or by the commission since the last inspection. The homes complaints policy was in the process of being reviewed along with all other policies & procedures in the home, by the registered manager. However the policy was reviewed during the site visit and was appropriate for this home. All staff have attended up to date POVA training and new staff attended POVA training during their induction. Staff were also given a copy of the GSCC code of conduct booklet on commencement with the home. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. The environment in this home is appropriate for the current residents. It is well maintained and the grounds are accessible for all residents. EVIDENCE: A tour of the whole home was undertaken during the site visit. There has been no change to the fabric of the building since the last inspection. There was evidence of on-going decoration being carried out and the home was generally well maintained throughout. At the time of the site visit it was clean and tidy and there were no malodours throughout. The inspector and manager discussed the on-going refurbishment and plans to increase the number of rooms available at this home. Information was given to the manager about the change in registration from the local offices to the regional team from September. Security in the home is good; on arrival at the home the doors were locked and a care assistant opened them, asking who I was before I was allowed in the home. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 16 There had been no change to the laundry since last inspection, however during the tour of the home it was noticed that there were CoSHH items on an open shelf in the laundry. This was pointed out to the manager and these were removed and locked in an appropriate cupboard before the end of the site visit. There is a stair lift that had been recently serviced and is only used by the residents in the company of a member of the care staff. As part of the plans to increase the number of beds at the home a passenger lift has been included in the design. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Staff skill mix and levels of training insured that the needs of the residents were met within this home. EVIDENCE: Staff rosters reviewed during this inspection demonstrated an appropriate skill mix for the dependencies of the residents at this home. The turnover of staff at this home is very low, which ensures continuity of care. Residents spoken to all is said that “staff always have time for you and never appear rushed,” when dealing with their personal care needs. Over 50 of the care staff at this home have National Vocational Qualifications at level 2 or above. All new staff that do not already have National Vocational Qualifications are offered a place on a course as soon as possible after their induction. Three personnel files were reviewed during the site visit. Supervision notes were kept separate from the personnel files. Recruitment procedures at this home are very good. The manager stated that she does not have any problems recruiting new staff. The majority that are taken on have learnt Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 18 about the vacancy through word-of-mouth, she has not had to advertise whilst shes been the manager of this home. The only staff that have left this home since the last inspection have either moved away from the area, or have gone to jobs which give them promotion. Criminal Records Bureau declarations are currently being returned within two weeks of application and the manager is getting POVA first declarations within two to three days. New staff undertake their induction under full supervision until the Criminal Records Bureau declaration is returned to the home. Certificates seen during the site visit demonstrated that staff statutory training was up-to-date. There were a number or other courses planned to run over the next few months and the manager demonstrated a commitment to all forms of training for the staff. Staff spoken to were very happy with the levels of training offered and were especially happy with the dementia course that some of them were undertaking at the time of the site visit. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. The overall management of this home is good and residents any of it from the procedures followed by the management team and the staff in the home. EVIDENCE: Although there had been a change of proprietor and registered individual for this home, since the last inspection, the registered manager remains the same and fulfils the criteria for the registered manager post. There has been no change to the quality assurance policy and procedures used in this home, which is a ‘bought in’ pack containing all the paperwork needed to carry out appropriate all audits and has been individualised for Asher House. The evidence showed that staff had a good knowledge of a number of the Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 20 policies and procedures and knew where to look for them if they wanted to refresh their memories about something, they also were observed to be following the policies and procedures set. There had been no resident or visitor questionnaires sent out since the new proprietor took over, the manager felt that it would be fairer to leave it for four to six months so that they are enabled to comment on the changeover if they wished to. The inspector left comment forms for both residents and their relatives to fill in and send back to the commission if they so wished. The registered manager, or her deputy managed resident’s personal allowances. Four personal accounts were checked during the site visit and all were correct. The accounts are well laid out and easy to follow. The manager is appointee for two of the residents currently. The manager was fully aware of her responsibilities with regard to financial abuse of residents especially as one of the residents has recently been granted guardianship order, which she had sorted out with social services. All staff have regular supervision, notes of each supervision session are kept in a separate folder and signed both by the supervisor and the supervisee. A separate sheet is kept listing dates and times of supervision so that the inspector is enabled to check how regular the sessions happen, without encroaching on the confidentiality of the information discussed. All appraisals were up-to-date at the time of the site visit. All certificates and servicing agreements reviewed were up-to-date and appropriate for the services offered by this home. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 21 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 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 3 X 3 Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The registered person should consider buying and fitting an appropriate control drugs cupboard in advance of any refurbishment programme. Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Asher House DS0000066638.V306983.R01.S.doc Version 5.2 Page 24 - 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. 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