CARE HOME ADULTS 18-65
Ashfield House Nursing Home Thornton Road Thornton Bradford West Yorkshire BD13 3LN Lead Inspector
Linda Trenouth Unannounced Inspection 18th October 2005 09:45 Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 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 Nursing Home DS0000019913.V257776.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 Adults 18-65. 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 Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ashfield House Nursing Home Address Thornton Road Thornton Bradford West Yorkshire BD13 3LN 01274 833133 01274 833856 louise.baines@brunelhousing.orguk 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) Brunel & Family Housing Association Limited Miss Louise Baines Care Home 19 Category(ies) of Learning disability (19) registration, with number of places Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 05 October 2004 Brief Description of the Service: Ashfield House is a large converted home located in a rural position on the outskirts of Thornton village, a few miles west of Bradford. The home has extensive grounds and is set in a picturesque location. Local transport facilities are situated near by and the local shops and facilities of Thornton are close to hand. Accommodation is provided in single and shared rooms on the lower ground, ground and first floors with wheelchair access throughout the home. There are lifts to all levels. The home has two lounge areas and a dining room. The home also has a (multi sensory) Snoozelan room. The home is a joint venture between Brunel Support Works Ltd and Bradford Health Trust, providing long term nursing care for adults with learning disabilities. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has to carry out at least two inspections of care homes every year. The inspection year runs from April to March and this was the first inspection visit for 2005/2006. Copies of previous inspection reports are available at the home or on the Internet at www.csci.org.uk. The last inspection of the home was on 5th October 2004. This was an unannounced inspection carried out by one inspector who was at the home from 09.45 until 13.30. The main purpose of this inspection was to make sure that the home continues to provide a good standard of care for the residents. The methods used at this inspection included looking at care records; observing working practices and talking to the residents, manager and staff. Comment cards were distributed to provide residents and visitors with the opportunity to comment on the service. Two comment cards were returned after the inspection, the responses were positive and are included in the report. What the service does well:
The staff at the home are welcoming and care is provided in a clean, tidy and well-maintained building, which continues to improve providing a comfortable home to a high standard. The standard of cleaning in the home is excellent, the cleaning staff continue to work to a high standard and ensure the home looks good throughout. Care staff seen throughout the inspection were kind and caring to the residents. Staff receive regular supervision and training to meet the needs of the residents and to provide a good standard of care. Residents personal and health needs are met, activities have continued to be positively developed by the activities coordinator. Residents have more opportunities for personal development and choice of social activity both in the home and within the community. The residents are supported to develop and maintain family relationships. They are encouraged to participate in residents forums. Residents said that staff are kind and caring and make them feel safe. They felt that home provides suitable activities. Staff recruitment and selection is robust and staff confirmed that they received induction and further development training.
Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 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. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4. All residents visit the home prior to moving in to meet other residents and the information helps them decide whether they want to live at the home or not. EVIDENCE: The newest admission to the home had had several visits to the home and overnight stays prior to moving in. A copy of the service user guide is made available. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Staff treat residents with dignity, helping them to participate in life at the home. Residents strengths and needs are not re-assessed or reviewed regulalry enough. Staff are not ensuring that the residents meaningfully participate in their care planning. EVIDENCE: Residents spoken to say that they helped in the home, one resident, regularly helped with setting tables. Another resident spoken to, said that he helped staff in lots of ways and like to be involved in the home. Discussion with the staff and review of records confirmed that care planning reviews and updating of assessments have not been done. For some individuals this had been for over a year. The requirement is that this takes place at a minimum of six monthly. Residents were not included in a meaningful way in this. The manager said that staff are implementing a person centred planning approach to care planning within the next few months. This will be reviewed at the next inspection.
Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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 and 15. Residents are encouraged to participate in social and leisure activities, to maintain links with their friends and family and to exercise choice and control over their lives. EVIDENCE: Residents are supported to help in the dining room and generally around the home. Two of the residents receive a payment for doing this. The activities coordinator has developed a varied and fulfilling programme of activities both within the home and wider community. This program is displayed in the home and includes group sessions for bingo, walking, outings and cooking. Individual based activities include, snoozelan and arts and crafts. One resident said she had particularly enjoyed a trip to Blackpool where she had seen Blackpool tower and been to the shops. Other residents had a trip to Beamish Museum, which had been thoroughly enjoyed. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 Residents physical and emotional needs are met. EVIDENCE: One resident said that the staff always ask him what he would like to do and assist him where he needs help. He added that he liked to do a lot for himself, which wasnt a problem for the staff. From looking at the records it was clear that staff managed complex and at times demanding needs. Staff said they felt well trained and supported by the management and able to meet these needs. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents and their relatives have their views listened to, taken seriously and action is taken to resolve issues. EVIDENCE: One resident said that he was able to talk to staff about any concerns he had. If he were upset or concerned about anything staff would help him. Staff had recently had training in adult protection training. The review of induction training and supervision for staff also confirmed that appropriate support networks were in place for staff to discuss their concerns. One resident said that they had meetings together to talk about if they were happy at the home. They also talked about the food and their holidays. All senior and care staff have regular monthly meetings and personal supervision. All meetings are documented and staff unable to attend can view copies. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 The residents live in a comfortable and clean environment. The bedrooms suit the residents needs and lifestyles. EVIDENCE: The areas of the home seen were very clean and well maintained. Communal and individual space presently meets the agreed standard with the provision of three communal rooms on the ground floor. The decoration and furniture is homely with comfortable furniture and good decor throughout. All of the residents bedrooms were seen. All were homely and comfortable. Each room clearly reflected the personality of the individual and were unique. From the bedrooms seen it was clear that residents are encouraged to buy furniture and items to individualise their rooms. The home overall is looking good with the windows of the house and conservatory having been recently replaced, and extensive redecoration throughout. The car park and drive is being resurfaced. The gardens continue to be well maintained.
Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 14 There were however some urgent maintenance needs. The roof had a serious leak in two areas. Adjustment also needed to be made to a bathroom door on the first floor and blinds needed to be provided for three bedrooms on the ground floor to make sure that adequate privacy is maintained. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33, 34, 35 and 36. The residents are supported by trained and supervised staff. The manager makes sure that there are enough staff are on duty in order to meet the needs of residents. EVIDENCE: The home meets the required standard for care staff in N.V.Q. training. This is commendable. All staff received induction training and progress to the L.D.A.F. foundation training. Mandatory training included moving and handling, health and safety, food hygiene and fire safety. Specialist training has also been undertaken in Challenging Behaviour, Adult Protection, First Aid and Palliative Care. In addition to this nursing staff are encouraged to update their training. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 and 42. The home is well managed. The interests of the residents are seen as very important to the manager and staff and are safeguarded at all times. Regular checks and staff training safeguard the Health and Safety of the residents. Wesley Gilbert the word largely EVIDENCE: The manager has many years experience in working with people with learning disability, and has completed the NVQ in management. The home is well organised and run and staff feel supported in their work. The building is maintained safely and the improvements to the environment are a reflection of the manager and staff commitment to the home and quality of life of the residents. Residents said that they are included in daily decision-making and their views and opinions are sought. Regular residents meetings are held and documented. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 17 The home has a responsible approach to the Health and Safety of the residents, staff and visitors. The control of infection and disposal of clinical waste was reviewed and was managed to a high standard. Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 2 4 4 2 3 4 4 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score 3 4 3 4 4 4 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Ashfield House Nursing Home Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x 4 x x x 4 x DS0000019913.V257776.R01.S.doc Version 5.0 Page 19 yes Are there any outstanding requirements from the last inspection? 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 YA6 Regulation 15 Requirement Care plans must be completed for each resident and updated regularly. Previously agreed timescale 6.12.04 Blinds must be fitted to bedrooms on the ground floor and the bathroom door on the first floor must be adjusted. The washbasins in the four new ensuite bedrooms are inadequate and must be replaced. Previously agreed timescale 6.12.04 Timescale for action 30/01/06 2 YA26 23 30/01/06 3 YA27 23 30/01/06 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 Standard Good Practice Recommendations Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Ashfield House Nursing Home DS0000019913.V257776.R01.S.doc Version 5.0 Page 21 - 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!
