Inspection on 23/02/06 for Ashfield Lodge

This inspection was carried out on 23rd February 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

Ashfield Lodge 24/07/06

Ashfield Lodge 06/07/05

Ashfield Lodge 25/10/04

Ashfield Lodge 07/06/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOMES FOR OLDER PEOPLE Ashfield Lodge Ashfield Road Sleaford Lincolnshire NG34 7DZ Lead Inspector Wendy Taylor Unannounced Inspection 23rd February 2006 09:00 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 Lodge DS0000059242.V284533.R01.S.doc Version 5.1 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 Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashfield Lodge Address Ashfield Road Sleaford Lincolnshire NG34 7DZ 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) 01529 307330 01529 414420 ashfield.lodge@craegmoor.co.uk Blair.house@craegmoor.co.uk Health & Care Services (UK) Limited Mrs Pauline Lesley Craig Care Home 20 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (14), Mental disorder, excluding learning of places disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (4) Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Ashfield Lodge changed its registration from an independent hospital to a care home on the 31/3/2004. The home now provides nursing care for up to 20 residents who have a dementia and or mental health problems. The home is a single storey purpose built facility close to the centre of the town of Sleaford. Accommodation is provided in single bedrooms each with en-suite facilities. There are also 2 lounge/dining rooms and an enclosed garden area with seating and plants, which are accessible by residents. The home is within walking distance of local amenities, such as shops, newsagents, hairdressers etc. There are car parking facilities at the front of the home. The home provides transport for the residents to enable them to use local facilities. Ashfield Lodge also provides day care services within the home but in a separate unit. The service provides transport, staff, meals and carer support. This service is however not registered by the CSCI and therefore not subject to inspection or regulation. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in February 2006 and it is the second unannounced visit to the home in this inspection year. Many of the key standards were inspected at the last visit and have therefore not been inspected at this visit. The home has complied with all requirements and recommendations made at previous inspections, and there were none made at this visit. A tour of the building took place and general observations of interactions and care practices were made throughout the visit. Resident’s files were looked at as well as general records within the home. Residents and staff were also spoken to. Residents said that they were treated very well and that staff they will help with anything they want. The atmosphere in the home was relaxed and pleasant on the day of inspection, and residents were being encouraged to engage in leisure activity. What the service does well: Residents receive sufficient information to allow them to understand the services provided by the home. They benefit from care plans that are clear, detailed and consistent and they are protected by risk assessments. They also benefit from a knowledgeable staff team who provide care in a respectful and dignified manner. Residents’ are supported to maintain choice and control in their lives, to whatever level they are able and they are encouraged to maintain relationships with family and friends where appropriate. They are protected by sound procedures for their personal finances and their health and safety needs are promoted. They benefit from a well-supported and supervised staff team and from comprehensive adult protection procedures. The home provides comfortable, clean and well-maintained surroundings that enable residents to retain as much independence as they are able. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 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 Lodge DS0000059242.V284533.R01.S.doc Version 5.1 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 Lodge DS0000059242.V284533.R01.S.doc Version 5.1 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): 1, 6 Residents receive sufficient information to allow them to understand the services provided by the home. EVIDENCE: The home has developed it’s service user guide and it is available to current residents and their families as well as prospective residents. The content of the service user guide is in accordance with the National Minimum Standards The home does not provide intermediate care. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 Care plans are clear, detailed and consistent and residents are protected by risk assessments. They also benefit from a knowledgeable staff team who provide care in a respectful and dignified manner. EVIDENCE: Admission details and initial assessments were seen to contain detailed health needs information including tissue viability needs, nutrition, dental needs and any specific physical illness. Care plans reflect the assessed needs and provide detailed information on how to meet those needs. Risk assessments were also in place for issues such as mobility. There was evidence of regular reviews for assessments, care plans and risk assessments, and all were dated and signed by the people completing them, the resident where they are able and their relatives. Staff said that there is a good daily handover procedure, which enables them to keep up to date with all residents needs and highlights specific interventions that are required. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 10 There are records detailing visits from health professionals such as GP’s, chiropodists and Psychiatrists. The home has a weekly visit from the Continence Advisor. Qualified nurses also have delegated duties for areas such as tissue viability, infection control and palliative care. Care plans refer to maintaining privacy and dignity for individuals and daily notes were written in a respectful manner. Staff were seen to interact with residents in a pleasant and respectful manner, and they were able to demonstrate a detailed knowledge of the residents needs. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents’ are supported to maintain choice and control in their lives, to whatever level they are able. They benefit from being able to maintain relationships with family and friends where appropriate and enjoy a balanced diet. EVIDENCE: The manager said that there were no set visiting times for relatives and friends, and this was confirmed during discussions with staff and residents. The manager also highlighted the arrangements for relatives who wish to stay overnight in the home, and these include a bedroom, shower room and a full menu. The importance of maintaining contact with family and friends is incorporated in the staff induction package, along with the importance of choice, dignity and empowerment. Choice for the individual is highlighted in care plans and there is information relating to advocacy services around the home. Although there are no residents currently using advocacy services, there is evidence in care files that relatives/representatives are fully involved in decision making and care planning. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 12 Staff were engaging in respectful interaction with residents and carrying out reminiscence therapy during the visit. Balanced menus that demonstrate choice were available in the home. Residents said that the food is generally very good, and one resident said that the cook always makes her whatever she asks for. There was a range of food seen in the kitchen, and the cook said that vegetables are purchased daily from a local supplier. The lunchtime meal was very well presented and the portions were ample. Nutritional assessments and care plans were available. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 Residents’ benefit from comprehensive adult protection procedures; and from the support of staff that are knowledgeable about the procedures EVIDENCE: The manager said that several residents are able to maintain their voting rights and they are encouraged to do so either by post or by attending a polling station with support. One resident was able to confirm this. The home has a comprehensive adult protection policy including the Local Authority guidance, and a policy for Whistleblowing. Staff demonstrated their awareness and understanding of adult protection issues, and records demonstrated that they are provided with training in relation to this. Notices were available in staff areas about Whistleblowing and adult protection. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,24,26 The home provides comfortable, clean and well-maintained surroundings that enable residents to retain as much independence as they are able. EVIDENCE: Hoists, bedrails, specialist baths, walking frames and wheelchairs are available throughout the home and there was evidence that all equipment is services regularly. All beds are fitted with low risk pressure care mattresses as a standard. Bedrooms were found to be comfortable and well personalised, with ample space to accommodate specialist equipment. All rooms also have en-suite facilities. Communal areas and bathrooms were also comfortably furnished and decorated. Bedrooms and bathrooms had signage on the doors to enable residents to identify the room correctly. Residents told the inspector that they liked their bedrooms and they were satisfied with the décor. One resident said that this was ‘the best home’ she had ever lived in. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 15 On the day of the visit the home was very clean and tidy, with a pleasant aroma and no evidence of clutter. Records show that two members of the domestic staff have achieved NVQ 2. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 There is an appropriately trained and knowledgeable staff team who are able to meet the needs of residents. The skill mix and numbers are appropriate to the needs of the residents. EVIDENCE: The home now has a copy of the residential staffing forum as recommended at the last inspection. Staff said that there are enough staff on each shift to meet the needs of the residents, including the availability of qualified nurses. Rotas demonstrate that the manager and deputy manager are also available during the day in addition to the care staff. There was evidence of a new handbook for staff, which they use from induction onward. The handbook includes training, supervision, appraisal and personal/career development records. Records show that the home maintains links with the local colleges for access to training and they also provide a range of company based training and information, including induction, dementia, infection control, epilepsy, care principles and medication. Staff said that they have access to good levels of training and development and they are allocated to work with an experienced member of staff throughout their induction. Eight care workers have currently achieved NVQ Level 2. The home also has access to a Clinical Governance Team through the parent company, whose role it is to ensure that current and best practice is maintained. The home has a range of reference material Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 17 related to health needs and health and safety issues, which is situated in the training office and accessible to staff. Staff said that they knew where to access this information. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,36,38 Residents are protected by sound procedures for their personal finances and their health and safety needs are promoted. They benefit from a wellsupported and supervised staff team. EVIDENCE: The home has a range of policies and procedures including lone working, Control of Substances Hazardous to Health (COSHH), use of bedrails and food safety. Health and safety information regarding fire, infection control and COSHH are displayed in the staffroom. COSHH materials were stored safely and data sheets were available. Records demonstrate that the home carries out weekly checks of fire equipment and alarms, water temperature, nurse call bells and window restrictors. They also show that all staff are trained as fire marshals. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 19 There is a comprehensive supervision policy within the home and records provide evidence that supervision takes place regularly. Staff said that they receive one to one supervision but they can also seek support from managers at any time. The home holds personal money only for residents, where there is a request or need and they have a comprehensive policy relating to resident’s finances. Records were seen to be satisfactory and money was securely stored. All money and records are kept individually and residents sign for their money where they are able. The manager carries out a weekly audit of the records and money, to which only herself and one other member of staff have access. Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 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 X 17 3 18 3 X X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 3 Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Ashfield Lodge DS0000059242.V284533.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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