Inspection on 16/07/07 for Ashfield House - North Yorkshire County Council

This inspection was carried out on 16th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashfield House - North... 01/08/06

Ashfield House - North... 31/01/06

Ashfield House - North... 12/05/05

Ashfield House - North... 28/09/04

Ashfield House - North... 08/04/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashfield House - North Yorkshire County Council Carleton Road Skipton North Yorkshire BD23 2BE Lead Inspector Caroline Long Unannounced Inspection 16th July 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashfield House - North Yorkshire County Council DS0000034620.V343590.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. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashfield House - North Yorkshire County Council Address Carleton Road Skipton North Yorkshire BD23 2BE 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) 01756 792 881 01756 795519 www.northyorks.gov.uk North Yorkshire County Council Post vacant Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2006 Brief Description of the Service: Ashfield House is a purpose built two-storey care home registered to provide a service for thirty-three older people of either gender aged over 65 years who do not have any specialist requirements. All bedrooms with two exceptions are intended for single occupancy. Bedrooms on the upper floor are accessed by a passenger lift. The home was built approximately thirty-five years ago and is located within a short drive of the centre of Skipton. The home is set in large grounds and has enclosed gardens There is a day-centre attached to the home, which offers up to ten places per day, which is managed by the homes manager but has its own dedicated staff team. The weekly fees on 24th July 2007 range from £368.90 and does not include costs for hairdressing and chiropody. This information was supplied to the Commission For Social Care Inspection via Annual Quality Assurance Assessment received on the 23rd July 2007. Access to inspection reports can be gained by requesting them from the home. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called annual assessment questionnaire. Information from surveys that were sent to people who live at the home, their relatives, health professionals and the staff. Nine surveys were returned from people who live at Ashfield House and two surveys were received from staff. An unannounced visit to the home. This was carried out by one inspector and lasted over seven hours and included talking to staff and the manager about their work and the training they have completed. And checking some of the records policies and procedures the home has to keep. Some time was spent talking with and observing people who live in the home. Four peoples records were looked at in detail. • • • What the service does well: The home is managed in the best interest of the people who live there this means they will be provided with a good service of their choice. Staff at Ashfield House are aware of the major life changes for a person moving into the home and provide people with the extra support needed to help them adapt. People who live in the home responded they all generally receive the care and support they needed and that staff listen and act on what they say. A positive comments made was: - ‘I am content and happy living here.’ People can be confident any concerns they have will be listened and responded to and the manager will consider them when looking at ways to improve the home. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashfield House - North Yorkshire County Council DS0000034620.V343590.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 Ashfield House - North Yorkshire County Council DS0000034620.V343590.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. People who use the service experience good quality outcomes in this area. People are provided with good information about the home and their diverse personal needs are identified and planned for before moving in, this make sure Ashfield House is the right place for them to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People who are considering moving into the home receive a information pack produced by North Yorkshire County Council, which contains specific information about the home and leaflets to address any other enquires they may have, such as the complaints procedure and data protection. All this information is available in other formats if needed. During the site visit, this information was on display around the home. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 9 Eight people responded in the surveys they did receive enough information about this home before they moved in so they could decide if it was the right place for them to live and one responded no. Positive comments made were: ‘Yes have attended day centre and knew about the home.’ ‘Mum came into Ashfield for recuperation from hospital and during that stay was offered a permanent place.’ ‘ I received information from care manager.’ Also a person who had recently been admitted explained how the staff had ‘understood the wrench of giving up their home’ and encouraged them ‘to talk about it’ which they said they had found helped. They also described staff spending time with them during the night and making them cups of tea. The manager explained she or a team leader would go out and assess all potential clients to make sure the service the home offers can meet people’s individual needs. Following this where possible, new people and their families are encouraged to come and look around Ashfield House before admission, when they are given information about the home. Also, once a placement has been agreed a welcoming letter is sent to the new person. Following this an initial review is held for them to make sure that the person is happy with their choice and the staff feel they are able to meet their needs. Two records were looked at of people who had recently moved into the home, both had all the information about the person which would have enabled the staff to make a decision of whether they would be able to provide this person with a good service. The manager was able to show records of where people had been assessed before they had moved into the home and she confirmed following a requirement made at the previous inspection where possible these were always carried out. The manager explained how people’s care needs were always reassessed when the staff did not believe they could meet them. During the site visit people in the home said they felt they were in ‘safe hands’, and the staff said they had received enough training to enable them to meet all of the needs of the people living in the home. When people move into the home they are provided with a named worker and the manager will try to make sure this member of staff is on duty when the person enters the home and following this carries out specific parts of their personal care and shopping. All people living in the home have a initial care plan from the care manager and agreement of care booklet thesse both act as the contract for the home. The benefits and assessment team calculate the cost of the stay and inform them or their representatives of the costs. Ashfield does not provide intermediate care. Ashfield House - North Yorkshire County Council DS0000034620.V343590.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. People’s health and personal care needs are assessed and are met promoting independence, choice and respect for individuals. However, to provide consistent and a safe approach to care, records need to be updated regularly. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People who live in the home responded on their surveys they all generally receive the care and support they needed and that staff listen and act on what they say. A positive comment made was: - ‘I am content and happy living here.’ During the site visit staff were observed to be providing care to people in a kind considerate and helpful manner, they were respectful towards people and appeared to be attempting to meet people’s needs in the way they preferred. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 11 A requirement was made at the last inspection that everyone must have a plan of care, during the site visit four peoples’ case records were looked at in order to check that a plan had been formulated which would help staff provide support to people according to their needs and wishes. All the records contained personal and health profiles which were completed on admission and plans of care, and identified the actions staff needed to take to care for the person properly. These were supported by risk assessments, which identified any possible risks and the actions needed to support these risks. There was evidence in the record of personal preferences that showed people were been consulted about their care. When talking with people omissions to the records were found. For instance where extra care was need for someone who was visually impaired or displayed challenging behaviour or was incontinent regularly on a night, the provision of this care was not reflected fully in the care plan. Although all these people had received the extra care they needed, for the person with visual impairment, food was arranged in a special way so it could be identified, talking books were being used. Also for the others the incontinence nurse had been consulted and the community psychiatric nurse. In all three cases, the staff had acted in the best interests of the people and the outcomes were good. To provide people living in the home with a consistent approach the manager needs to make sure any changes or extra care provided is written in the care plan. The manager and records confirmed staff have received care plan training, and staff confirmed they were involved in the care planning process and used them when they wanted to find out information about people. Also, how the home used the initial personal and health profiles to identify people’s equality and diversity needs and to help them promote this whilst caring for people. Records were kept to provide a good picture of the lives of people but not all were kept daily. To improve communication and help provide essential information to track any changes people may experience, with ill health or involvement in social activities for instance, the home should consider writing these on a daily basis. People’s health care needs are promoted and maintained. The records showed people were accessing health care professionals, such as General Practitioners, Chiropodists, and District Nurses. The six surveys returned from people living in the home also confirmed they always receive the medical support and equipment they need. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 12 Comments made were: ‘Physiotherapist visits and updates action needed.’ ‘Doctor will visit if I ask for him or at other times if staff think he should be asked for a visit they will arrange this.’ Also, the information provided by the manager before the site visit states links with the community mental health team have been strengthened and they are supportive regarding any mental health issues for individual clients. The home operates a named worker system where people in the home are allocated a preferred member of staff to help them with specific personal care needs or to spend one to one time with or carry out personal shopping for. A member of staff explained how following the recruitment of male staff, males living in the home were now able to have a male named worker. There is a medication procedure to guide the staffs practice and training is provided on safe storage, administration and disposal of medicines. Following requirements made at the last inspection in 2006, improvements have been made to the administration, storage and recording of medication. The home now operates a weekly monitoring system and a number of staff has completed medication training. However medication is dispensed during meal times, the manager needs to reconsider this practice as people often do not like to take medication during their meals, as it can be unpleasant and it is often left by the staff for them to take later, which is unsafe. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. Social, cultural and recreational activities are not meeting all peoples expectations. People living at Ashfield House receive a healthy and varied diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: At present, the home offers a chair exercise class on a Tuesday and quizzes and bingo on a Thursday and Friday afternoon. During the site visit, people were generally sat in the main lounge area listening to the radio or talking, no other activities were taking place. People mostly said there were not enough activities arranged by the home they could take part in. Comments made were: ‘No activities, boring, just sit around and have TV on.’ ‘Sometimes play bingo and join exercise class.’ ‘There are not enough activities to help the days pass by.’ Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 14 Staff also commented in their surveys and during the site visit about the lack of activities for the people living in the home. However discussion with the manager evidenced they were aware of this and had recently commenced residents meetings, and they were developing a programme of the activities which people wanted to be involved in. Also, they had the recruitment of a new member of staff which would enable them to commence visits to out to local venues. Relatives were seen being made welcome by the staff during the site visit and staff explained they are welcome to stay for meals in whatever environment they wish. The home has links with the local advocacy group if required. People in the home said they live the lifestyle they choose and they can retire and rise when they want, and most of the staff confirmed this. However there were comments made by one member of staff that pressure was on to make sure people were in their bedrooms by 10pm but another explained how most went to bed before 10pm and if they were left later they would often ring and ask why they were late to bed. In the dining room meals were treated as an occasion, people said they enjoyed and looked forward to the time they spent talking with others, tables were set with table clothes; napkins, and tea pots were available on the tables for people to use. During the site visit and on the surveys people said the food was generally very good. Comments made were positive: ‘Food is very good and I enjoy it.’ ‘I enjoy most foods we have a choice.’ Although there was only one choice on the notice board, some people were unaware of the varied choice of main menu that was available. The home should consider writing all choices on the menu board so everyone can be made aware of the variety of food offered, also the use of tureens so people can choose the amount of vegetables they want. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People who use the service experience good quality outcomes in this area. People have access to an effective complaints procedure and are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: During the site visit, people were seen to be comfortable approaching the manager and staff and making their views known. People who lived in the home also said they felt comfortable to approach the managers and staff with any complaints. There are regular meetings where people are asked their views about the services the home offers. Surveys returned by people living in the home generally said they would know who to speak to if they were unhappy and were aware of how to make a complaint. Comments made were: ‘Not afraid to speak my mind.’ ‘Would speak to one of the managers.’ However, one person did make the comment - ‘Not sure who I would turn to.’ Ashfield House follows the policy and procedure by North Yorkshire County Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 16 Council when dealing with complaints, which look to resolve complaints sensitively, quickly and effectively. If necessary the home can refer a complaint to or consult the Local Authority headquarters who have a special complaints team. The home uses complaints to learn from and to inform their annual improvement plan. Leaflets and posters are distributed through out the home and there are leaflets available about the local advocacy service. No complaints have been received by the commission and the records kept by the home showed they had received one complaint where money had gone missing from someone’s room, the police had been informed and a investigation had been carried out by the home. There is a comprehensive policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse. The manager and staff spoken with during the site visit were aware of the actions to take to safeguard adults. Discussion with the manager and the records showed many of the staffs training plans had identified safeguarding adult training as a training need. She explained this training was to be provided for all the staff working in the building. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use the service experience good quality outcomes in this area. People who live at Ashfield house live in a safe, comfortable and clean environment, which staff endeavours to make their home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has undergone a period of refurbishment the lounge and dining room have been decorated, and provided with new carpets, flooring, curtains and furniture. Also, any bedrooms that have been empty have been decorated and provided with new carpets, and curtains. Televisions have now been put at eye level. This had made the home brighter and homely for the people living there. Whilst carrying out these refurbishment the staff have sought the views of Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 18 people living in the home. With peoples agreement two bedrooms were visited both contained personal possessions which were age and cultural appropriate to the them. Both said their rooms were ‘small but adequate’ and ‘alright’. One describes how they were able to bring in their own bed and furniture both into their bedroom and into the communal lounge. There are no en-suite rooms but the home has four bathrooms one on each corridor and bath and shower room on the ground floor. During the forth coming changes to the home, when a dementia unit is to be established the manager hopes a wet room will be installed to provide people with a choice of bathing and to help promote independence in personal care. The home is kept spotlessly clean so that the risk of people becoming ill from poor hygiene is unlikely. The communal areas were free from offensive smells for the duration of the inspection and made the environment pleasant. People surveyed said that this is always the case. Gloves and aprons are available throughout the home so as to minimise the risk of cross infection from one person to another. However one of the bedrooms had an unpleasant odour, this was raised with a member of staff who agreed to find out the cause and resolve it immediately. The home has a handyman who carries out various health and safety checks and the routine maintenance. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use this service experience good outcomes in this area. Staff are trained to ensure people receive the care and support they need. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There were many positive comments made about the staff by the people in the home during the site visit. Words used were ‘kind’,’ helpful’,’ wonderful’ and, ‘will always help’. All staff observed during the site visit were kind and attentive, there were positive relationships observed which were jovial and warm. Eight of the people living in the home responded in their surveys that staff listen and act on what they say. However there has been a mixed response from people living in the home and staff about whether there are enough staff on duty to meet all peoples identified needs. Comments made have been: ‘Sometimes I ring for help in room but have to wait when staff are busy.’ ‘Staff are very good but they are short staffed.’ ‘They are always busy, short staffed.’ Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 20 Comments made by staff implied when everyone was working and there was no sickness or leave they were able to meet peoples personal care needs, but they did find it difficult to have any meaningful time or carry out any social activities with people in the home. The manager explained she had attempted to rearrange the rotas and give staff a responsibility of a group of people when they work to make sure peoples personal needs were now met. Also a further member of staff was shortly to start and she hoped this would alleviate any problems. The manager needs to continually review the staffing numbers to make sure people living in the home are provided with a stimulating and fulfilling lifestyle. Staff confirmed they have received induction training and where they had worked at the home for a number of years their training had been up dated. Training covered was health and safety, food hygiene, back care, and medication. Also, many of the staff team have completed equality and diversity training, which has raised staff awareness and helped many staff feel more confident in challenging any forms of discrimination. Other specialist training has taken place such as dementia and dyslexia and management. The management are committed to providing staff with the skills they need to be able to provide people with care properly. Therefore learning is also carried out during, team meetings, key worker meetings, supervisions, and skill sharing sessions with other professionals and colleagues. Currently there is a staff team of thirty-eight and, over half have now completed their national vocational qualification in care at level two or above. Four staff files were checked, the personnel department of North Yorkshire County Council carry out all the recruitment checks and the home follows their procedure. The staff in the home are able to see all the documentation before an interview is agreed. In the four staff file looked at copies of application forms had not been taken, and the originals had been sent back to the head office, so it was difficult to assess if people had been recruited properly. The manager was aware of this and was attempting to obtain copies for the home. All staff records are kept in one file, however to keep within data protection guidelines the home should look to keeping these records on individual staff files. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. People who use this service experience good outcomes in this area. The home is managed in such a way that promotes the best interests of people. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager has had many years of experience working in care homes she has commenced her national vocational qualification level four in care and registered managers award and is in the process of applying to be registered by the Commission. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 22 Since taking up the post last year she has reviewed many of the practices and procedures and has made many improvements to Ashfield House which have benefited the people living in the home. Discussions with her showed she has a good understanding of how to meet the diverse needs of all the people living in the home. The registered manager explained to make sure the staff are aware of peoples views about the service, regular meetings are held, a comments book is left in reception and staff are open to listening to their points of view on a day to day basis. The locality manager carries out regular visits where they will speak with people in the home and visitors for feedback. Quality assessment surveys are carried out monthly, where the locality manager speaks to clients and visitors for feedback. The locality manager also holds monthly and quarterly meetings with the manager, where they monitor any improvements or setbacks. The administration assistant explained people are encouraged to keep financially as independent as possible. Where people request that the home holds money for them, financial procedures are followed, and good recording practices are in place. This good practice is checked six monthly by the local authority financial team. Staff said and the records confirmed that supervision is carried out regularly and staff are receiving annual appraisals. All spoken to said they felt supported by the manager. Information provided by the manager in the annual assessment confirms the home makes sure they are working in a way to promote the health and safety of people who live in the home. Training covers manual handling, fire safety, first aid, food hygiene, infection control and assessing risks. There is a designated person in the home that carries out a Health and Safety inspection report every six months. The manager was able to confirm all the electrical work has now been completed and the records confirmed the gas safety records were now up to date. Water temperatures and fire records were looked at both had confirmed the home were monitoring health and safety and carrying out regular check and complying with relevant legislation. Risk assessments were in place. At the previous inspection a requirement was made for the home to improve its record keeping, at the site visit all the records had improved greatly. Good record keeping makes sure that staff receives the necessary information to help them look after people properly. However, the manager needs to make sure all records are kept in a way, which meets data protection guidelines. Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 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 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement To make sure people in the home receive care safely and staff follow a consistent approach. The manager need to make sure people’s care plans accurately reflect the care they require and are provided with. Timescale for action 01/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations To make sure people living in the home are receiving the correct medication, and in a time they find acceptable, the manager should review the practice of dispensing medication at meal times. Efforts should continue to be made to develop a meaningful programme of social activities for the people living the home and tailored to their needs, wishes and abilities. People should be able to remain in contact with local community by, for example, being regularly taken out. DS0000034620.V343590.R01.S.doc Version 5.2 Page 25 2 OP12 Ashfield House - North Yorkshire County Council 3 OP21 To provide people with a choice of how they wash and to help them maintain their independence, the home would benefit from a wet/shower room. To make sure everyone’s bedrooms are comfortable and fresh, they should be free from offensive smells. The manager needs to continually review the staffing numbers to make sure people living in the home are provided with a stimulating and fulfilling lifestyle. To help the management make informed decisions about staff a copy of the applicants application form needs to in the home. The help provide a consistent service the manager should register with the Commission. The manager should review the way it keeps some of the records to make sure they are in line with data protection. 4 5 OP26 OP27 6 OP29 7 8 OP31 OP37 Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashfield House - North Yorkshire County Council DS0000034620.V343590.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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