Inspection on 24/07/06 for Ashfield Lodge

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 23/02/06

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 Key Unannounced Inspection 24th July 2006 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 Lodge DS0000059242.V304823.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 Lodge DS0000059242.V304823.R01.S.doc Version 5.2 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.V304823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 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. The current fees for the home are £587:00 to £605:00 Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on July 24 2006 over a 6-hour period. The care received by four residents was looked at in detail. Individual residents records and general house records were looked at; residents, relatives, staff and the registered manager were spoken to, and an observation of how care is provided was made. Feedback from other residents was gained from surveys carried out prior to the visit. Residents and relatives said that they were pleased with the care provided. What the service does well: What has improved since the last inspection? What they could do better: A high standard of care and support is maintained within the home and they meet and in some cases exceed the key National Minimum Standards. Some areas for development were discussed with the registered manager during this visit such as recording that pre-admission information has been given to prospective residents and families, and that there are clear care plans for personal finances. Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 6 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.V304823.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 Lodge DS0000059242.V304823.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. The judgement has been made using the available evidence including a visit to the service. There are sound pre-admission assessments in place to assure people that the home can meet their needs. EVIDENCE: Assessments are available for individual residents and a new format is currently being put into use. The format includes residents and relatives’ expectations of the proposed admission and their perspective of their needs. It confirms equipment that will be needed, staffing hours and skills and any other resources needed to provide care. There is a detailed mental health needs assessment as well as those for nutrition, dental care, tissue viability, moving and handling, health promotion and personal safety. The registered manager said that she provides prospective residents and/or their families with a service user guide, statement of purpose and a contract, which were seen during the visit. She also said that they are encouraged to visit prior to admission if they are able. Relatives said that they got lots of Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 9 information and booklets from the manager prior to their family member being admitted to he home. The registered manager said that she would record when she has given pre-admission information in future. The home does not provide intermediate care. Ashfield Lodge DS0000059242.V304823.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): 7,8,9,10,11 Quality in this outcome area is good. The judgement has been made using the available evidence including a visit to the service. Residents benefit from having care plans which address their assessed needs and wishes. They are protected by medicine policies and procedures; and their privacy and dignity is upheld. EVIDENCE: Care plans are available for individual residents and they cover needs such as social stimulation, diversional therapy, behaviour management, use of bedrails, personal hygiene and pain. The care plans also refer to dignity, comfort and respect. There is evidence that care plans are reviewed regularly and that residents and relatives are consulted. Relatives said that staff talk to them about their family members progress and needs on a regular basis. There are currently no care plans relating to financial needs, but the registered manager said that new care plan formats are to be implemented in the near future and standard finance plans are included. She said that she would ensure they are completed. Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 11 There are clear records kept of professional visits for example from GP’s, dentists, chiropodists and psychiatrists. There are up to date records of residents weight available on individual files, and end of life wishes are also clearly recorded. Staff were observed to be respectful and patient, especially when residents were upset, and relatives said that staff are attentive and look after people’s need very well. Medication records were completed satisfactorily as well as administration and storage procedures. Staff were seen taking time to help residents take their medicines, they gave appropriate explanations to them and talked to them about their individual need for pain control. There is a detailed medication history available on residents’ files. Ashfield Lodge DS0000059242.V304823.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. The judgement has been made using the available evidence including a visit to the service. Residents enjoy a balanced and wholesome diet and are supported to keep as much choice and control in their lives, as they are able. They are also able to join in a range of activities and are consulted about the programme. EVIDENCE: Three weekly menu plans were available with a vegetarian option for each day. Residents said that they liked the food that is provided and there are alternative options available for them whenever they want. Residents were being asked what they wanted to have for breakfast and lunch, and the meals were well presented. The atmosphere during meal times was relaxed and comfortable. Two people had asked for meals that were different to the choices available and these requests were met. Staff were encouraging residents to take drinks regularly throughout the visit, as it was a hot day. There was a good selection of food available in the kitchen, including a range of fresh vegetables. The registered manager said that individual menus have been produced where necessary or requested. Relatives said that interaction between staff and residents is very good even though their family members cannot always join in group activity. They said Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 13 that they can visit at anytime and staff always welcome them and offer them drinks. There is evidence that a meeting is arranged for next week to plan a new activity programme. The meeting will include staff and residents. There is evidence in records that individual sensory-based sessions are carried out and residents said that they do have a good range of activities. There is evidence of a recent summer fete. Day centre staff also do activity with any resident who wishes to join them. Ashfield Lodge DS0000059242.V304823.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. The judgement has been made using the available evidence including a visit to the service. Residents are protected by sound policies and procedures, and they are able to express their views and concerns. EVIDENCE: There have been no complaints or reports of adult protection issues since the last inspection. Residents said that they would be happy to talk to staff or the registered manager if they have a problem with anything, and relatives said that they have no concerns at present but they would talk to the registered manager or The Commission if they had. There is a copy of the complaints policy displayed in entrance hall, and it is in the service user guide. Staff demonstrated that they have a good knowledge of adult protection procedures and they knew about residents needs in detail. There were dates for forthcoming training in adult protection issues posted on staff notice board. There was evidence of a recent audit of residents’ personal money that is kept at the home (see Standards 31-38). The manager said that residents are supported by relatives or others to manage their overall financial affairs. Ashfield Lodge DS0000059242.V304823.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): 19,25,26 Quality in this outcome area is good. The judgement has been made using the available evidence including a visit to the service. Residents benefit from a safe and comfortable environment, in which any issues with décor and maintenance are addressed immediately. EVIDENCE: Residents made comments such as ‘it is a wonderful home’ and ‘there is a lovely garden’. The home was clean, fresh and there were no obstructions to residents’ mobility. Furniture and décor was in good order. Relatives and residents commented on the quality of the laundry. Residents and relatives said that they can decorate and personalise bedrooms, and that the cleaning staff keep the rooms very clean and tidy. Carpet in corridors and other communal parts were stained and worn and in need of attention. The registered manager said that she has already requested renewal of floor coverings and provided proof of this. The kitchen and food storage areas were clean and tidy and hazardous substances were stored appropriately. Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 16 Ashfield Lodge DS0000059242.V304823.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 excellent. The judgement has been made using the available evidence including a visit to the service. There is a well-trained and consistent staff team who are recruited in a way that protects residents. EVIDENCE: Records demonstrate that staff have undertaken training in health and safety, basic food hygiene, fire safety, risk assessing, infection control, manual handling, adult protection, continence and Control Of Substances Hazardous to Health. There is evidence that dementia and first aid training are scheduled for the near future. Staff said that they have good access to training, including a good induction package. They said that there is good teamwork at the home and clear management guidance and support. The registered manager demonstrated that all staff except three people on the induction programme are currently or have undertaken a National Vocational Qualification at level 2. Rotas demonstrate that there is a consistent number of care staff and nursing staff on each shift, and staff said that there are enough staff to meet residents needs. There are satisfactory arrangements in place for any vacant shifts to be covered by a team of staff who are known to the residents. Call bells are answered promptly and staff were responding to general requests from residents in a timely and respectful manner. Staff files contain all information required under Schedule 2 of the Care Homes Regulations 2001. Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 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): 31,33,35,38 Quality in this outcome area is excellent. The judgement has been made using the available evidence including a visit to the service. There is a sound management approach and quality assurance programme within the home, which ensures that the residents’ best interests are promoted and protected. EVIDENCE: Staff said that the registered manager will help with care provision so that she knows what is going on in the home, and they feel very supported by her. They said that they receive regular supervision and have regular staff meetings; and they are encouraged to speak out and bring in new ideas. Care plans are cross-referenced with risk assessments for issues such as pain, use of bed rails, behaviour and mobility/falls. Policies are in place for adult protection, quality assurance, continence promotion, confidentiality, equal opportunities, first aid, residents’ finances, Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 19 physical intervention, privacy, dignity, choice and independence. Assessments relating to hazardous substances were reviewed and updated in February 2006. The registered manager said that residents and relatives surveys are carried out by the company’s head office and then the home is informed of the outcomes, she said that the next survey is due to be done in August 2006. There is evidence that, since April 2006 audits of health and safety issues, residents finances, medicine procedures and a care overview have been carried out. Records show that there is regular monitoring of water temperatures, window restrictors, fire alarm points, the nurse call system and bedrail maintenance. They also show that hoists and wheelchairs are regularly checked and serviced. Fire equipment was serviced in December 2005 and a fire drill was carried out in February 2006. Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 STAFFING Standard No Score 27 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 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.V304823.R01.S.doc Version 5.2 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. Extracts may not be used or reproduced without the express permission of CSCI Ashfield Lodge DS0000059242.V304823.R01.S.doc Version 5.2 Page 23 - 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!