Inspection on 14/08/07 for Ashfield Malton - North Yorkshire County Council

This inspection was carried out on 14th August 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 Malton - North... 23/10/09

Ashfield Malton - North... 12/09/06

Ashfield Malton - North... 06/02/06

Ashfield Malton - North... 23/08/05

Ashfield Malton - North... 23/02/05

Ashfield Malton - North... 06/10/04

Ashfield Malton - North... 10/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

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 Malton - North Yorkshire County Council Ashfield Malton Old Malton Road Malton North Yorkshire YO17 7EY Lead Inspector Gill Sample Key Unannounced Inspection 09:30 14th August 2007 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 DS0000034316.V334128.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. DS0000034316.V334128.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashfield Malton - North Yorkshire County Council Address Ashfield Malton Old Malton Road Malton North Yorkshire YO17 7EY 01653 692371 01653 699211 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) www.northyorks.gov.uk North Yorkshire County Council Mrs Jennifer Ann Beard Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places DS0000034316.V334128.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2006 Brief Description of the Service: Ashfield is a care home providing personal care and accommodation. It is registered for thirty four older people. However, when double rooms are being used as single rooms a maximum of thirty one people can be accommodated at any one time. North Yorkshire County Council owns the home and Jennifer Beard manages it. It is located approximately half a mile from the centre of Malton near to shops, the post office and amenities. The home is an adapted property and is set in its own grounds. The grounds are well maintained and accessible to people living at the home. There is also a passenger lift so that people have access to all floors of the home. A copy of the service users guide to the home is given to prospective residents who are offered a visit to the home prior to making a decision whether to move in. A copy of the latest Commission for Social Care Inspection Report is available for prospective residents and their relatives to read. The weekly fee on the date of the inspection is £368.90. Additional charges are made for private hairdressing and chiropody, newspapers, taxi fares, toiletries and for items bought from the home’s shop. DS0000034316.V334128.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: ● ● ● ● ● ● Reviewing information which has been received about the home since the last inspection Information provided by the manager on a pre-inspection questionnaire Comment cards returned from people living at the home Written surveys from relatives, carers and advocates of residents Written surveys from health and social care professionals involved with the service A visit to the home on 26th June 2007 The visit to the home lasted two hours and forty five minutes. Two inspectors spoke to people who live at the home, the registered manager Jennifer Beard staff on duty and visitors to the home. Records relating to people living there, staff and the management activities of the home were inspected. Care practices and routines of the home were seen. This helped the inspectors gain an insight into what life is like at Ashfield for the people who live there. The registered manager Jennifer Beard assisted the inspectors and she was given verbal feedback at the end of the inspection. What the service does well: Ashfield provides good outcomes for the people who live there. General comments made about Ashfield were good “I like being here, I have a nice room and the food is good”. “I get very well looked after here”. “It’s a good place. It’s like a holiday camp or hotel”. The home is well managed and the manager and staff are supported by the organisation to provide care. All health and safety checks and systems are in place so that residents live in a safe home and checks on the quality of care are followed up if they fall short of expected standards. There is an open and friendly atmosphere at the home, which was commented on by residents and visitors. “I am very happy here”, “I feel settled” and “My visitors are always made to feel welcome”. The home has a high standard of cleanliness and is well furnished and decorated. It has spacious sitting rooms so that people living there can choose where they sit. The building is maintained well so that people living at the home have a good standard of comfort and safety. DS0000034316.V334128.R01.S.doc Version 5.2 Page 6 Staff are kind and attentive to people’s needs. Comments made by people living at the home included “staff are very pleasant and help me when I need assistance” “I get well looked after. Staff are very good”. “I feel privileged to be here”. People are offered a good choice of food and drinks and are able to eat their main meal either midday or evening. Comments about the food were good. One said “It’s marvellous. The only complaint I can have is that they give me too much”. “I’m very happy with the food”. 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. DS0000034316.V334128.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 DS0000034316.V334128.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): 3. Standard 6 does not apply. People who use the service experience good quality outcomes in this area. Prospective residents will have chance to experience the service, their individual needs will be assessed and recorded prior to entering the home and they will be given information so they know what to expect. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Examination of three residents’ files showed that comprehensive assessments of need are made and recorded before anyone is offered a place at the home. Every person is offered the opportunity to visit the home prior to moving in so they have a chance to experience what it might be like to live there and talk to other residents about the home. One recently admitted resident said that his two daughters had looked at Ashfield and told him about the home and its facilities. The manager or team manager from the home visits prospective residents to complete the assessment. Where a care manager is involved in purchasing the care, their assessment is used as a basis for the home’s assessment. Records showed the personal preferences of individuals and what they wanted people to call them. DS0000034316.V334128.R01.S.doc Version 5.2 Page 9 A key worker is allocated to each resident and their role is to ensure that new residents settle in and have information about the service on a day to day basis. Having been at the home for a few weeks, one resident said “I was made welcome. I’m feeling settled”. Residents’ surveys confirmed that people were given information about the home before they moved in which helped them decide whether Ashfield was right for them. DS0000034316.V334128.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): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. They can be assured that their health care will be properly monitored and dealt with and that their physical, social, psychological and emotional needs will be recognised and met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Plans setting out the care needs of residents gave good information for staff on what care is needed and how the person preferred their care to be given. These records were readily available to care staff so that they could understand individual care needs and record the tasks they had undertaken. Care records provided an easy to follow record of any change in care needs. Key workers had undertaken monthly reviews of people’s care needs and had recorded these clearly so that all care staff knew and understood the tasks they needed to do. Care records showed when residents had needed attention from health care professionals. A visiting health care assistant said that she felt that excellent care was given by staff at the home and they followed any advice given about DS0000034316.V334128.R01.S.doc Version 5.2 Page 11 the health care of residents. Matters relating to health such as the monitoring of weight were recorded. Staff were mindful of the need to ensure that people’s care is delivered while respecting privacy and dignity. Staff were seen talking to residents with respect at the visit. Care records showed an emphasis on promoting the independence of people so that they could continue to do things for themselves. Toilet facilities had been refurbished so that people can use toilet facilities with greater privacy. Residents said that they liked staff at the home “Staff are very good” “They’re marvellous”, and “they’re a real good help”. Written comments from relatives about the staff were also good “staff are friendly and approachable”. Medication policies and procedures are in place so that staff can deal with medication in a safe manner. While administration of medication was not observed, storage and the recording system was seen. Staff undergo training to ensure that they are competent to deal with medication, and information sent prior to the inspection visit confirmed which staff had completed this. DS0000034316.V334128.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. Daily life and social activities offer service users opportunities to live their preferred lifestyle, contribute to their own and others lives within the home, and retain relationships in the wider community. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Notices were seen detailing a range of activities for the current month. A volunteer is involved with residents, providing activities for three to four hours a week. Residents were seen reading newspapers, crocheting, knitting and chatting with each other. People said that they did as they wished, using different sitting rooms to talk with other people. One said that they had their own television and sometimes watched their favourite programmes in their room. Residents had been involved in the wedding of a member of staff and had joined in with the wedding guests for dancing and celebrations. Care records detailed how staff were to ensure that people would remain independent so that they retained as much control as possible over their lives. People’s wishes about being checked overnight were recorded. One General Practitioner commented that the service “respects the autonomy of residents”. Residents’ meetings are held so that people get the chance to be involved in the running of the home and influence their care. DS0000034316.V334128.R01.S.doc Version 5.2 Page 13 Lunch was being prepared during the visit and included a choice of hot food or sandwiches with chips. The cook said that residents would be served a cooked tea and that the choice seemed to suit people as they had choice. The dining room has been redecorated and is light and airy with space for people to sit and enjoy their meals. People said they had family to visit and the visitors book had comments such as “Dad happy today” along with a ‘smiley face’ symbol. Visitors are able to visit when they wish and information for visitors is posted in the hallway and office door so that they are aware who is in charge. A resident said “I have relatives visit me every Saturday”. DS0000034316.V334128.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. Service users are able to make a complaint using information provided by the home and are protected by the awareness of staff of potential abuse. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There is a clear complaints procedure which is detailed for people in the home’s service user guide. The surveys done as part of the home’s quality assurance last year detailed that residents and their relatives did not know how to complain, and the manager had taken action to ensure that people knew what to do if they were not happy with the service. To check that people know how to complain, questions have been included in the quality assurance survey for the current year. Several suggestions had been made by residents on how to improve their daily lives which might otherwise have resulted in complaints. There had been no complaints since the last inspection of the service. Leaflets about a local advocacy scheme were available for people if they needed independent help and assistance. The policies and procedures regarding the protection of residents are robust and in line with best practice. All staff are provided with training and are made aware of the need to report any allegations or suspicions of abuse to their manager. Management know and are experienced in the measures to take in relation to safeguarding adults. The system for handling residents’ money was seen which was properly recorded. DS0000034316.V334128.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. The home is a clean and pleasant place in which to live which is maintained to a good level of comfort and safety. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All general areas of the home were seen and some bedrooms, bathroom and toilet facilities. All areas seen were light and airy, well decorated and furnished, and gave residents choice as to where they spend time. Improvements have been made to the interior of the building with several rooms re-carpeted and decorated. The ground floor toilet facilities, which had previously been in cubicles with partition walls had been refurbished to provide individual enclosed toilet facilities each with its own wash hand basin. This means that people using toilet facilities have better privacy. The building is easily accessible and provides a safe and well-maintained environment so that residents have a good level of comfort and safety. Adaptations have been made to the building and equipment is provided so that DS0000034316.V334128.R01.S.doc Version 5.2 Page 16 people are able to use the facilities and move around the home independently. There is a wide choice of places where residents can sit and a secure mature garden provides opportunities to sit in the open air. The home employs a handyman who is responsible for routine maintenance and the monitoring of some health and safety aspects of the premises. Comments about the home from residents were “I like being here. I have a nice room”. A relative said “Ashfield is a very pleasant home with lovely surroundings, décor, etc.” DS0000034316.V334128.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. The safety of residents is promoted through a robust recruitment process and being looked after by a well-trained and supervised staff group. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All staff spoken to considered that they were well supported by the management of the home. One to one supervision sessions are held every six weeks and a record is kept of the discussion. These were seen on staff files examined. However, the names of residents for whom the staff member was a key worker were included in their individual supervision record and this is referred to later in this report. Monthly staff meetings are held and minutes were displayed on the staff notice board. Staff are trained on a rolling programme in health and safety topics and, following induction and foundation training, undertake NVQ Level 2 in care. Staff records seen and staff spoken with at the visit confirmed this. One staff member had started work towards an NVQ Level 3 qualification. The staffing rota was seen which tallied with the staff on duty at the visit. Staff said that they managed to care for residents when three staff are on duty, but that when only two staff were working it became hard to care for all the residents’ needs. The manager said that there had been two occasions over the previous two weeks when agency staff failed to arrive when only two care staff were at work. Staffing levels are only a problem when someone goes off DS0000034316.V334128.R01.S.doc Version 5.2 Page 18 sick and is not replaced on the rota. There were problems with the call system during the visit so that one person needing help could not call care staff to help them. Three staff files were seen which contained information gathered in the recruitment and selection process. The procedure requires applications to complete a written application form detailing their previous experience, written references are obtained and a criminal records check is made prior to making any appointment. Criminal records disclosure information were being held as original documents. The manager was advised that these may be held as a list and that guidelines can be found on the CSCI Website. One record showed that an applicant had had previous experience as a care worker in a registered service but that references had been taken up from those quoted by the applicant. This means that an opportunity to gather relevant information about the applicant’s ability to look after people was missed. DS0000034316.V334128.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38 People who use the service experience excellent quality outcomes in this area. The home is well managed which promotes good service delivery in the best interests of residents. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager Jennifer Beard is qualified and experienced in managing services for older people. She keeps herself updated on current best practice through training opportunities. Information sent prior to the inspection showed that different responsibilities are undertaken by the manager and senior staff at the home so that all aspects of managing the building, the service provided and staff are covered. Residents have regular meetings so that they have a chance to raise any issue, make suggestions and influence the way the service operates. Issues raised during the home’s quality check have been dealt with by the manager so that DS0000034316.V334128.R01.S.doc Version 5.2 Page 20 the quality of life of residents is improved. For example, feedback from the process said that the home’s notice-board was too high for residents to read easily and so this had been lowered. Other findings of the quality assurance questionnaire had been addressed and were the subject of this year’s check, so that improvement can be monitored. The home has good policies and procedures in line which are reviewed regularly and based on good practice. Staff are kept aware of the procedures by being briefed on a monthly basis and being given a shortened version of the procedure. The system for handling people’s money was seen in practice. This requires all transactions to be recorded so that people and their relatives know what money is being held by the home and are protected by sound procedures. All entries seen were initialled by two members of staff. Staff supervision records contained the names of individual residents. Reference to any resident needs to be detailed using initials only so that personal information is protected and records comply with data protection legislation. DS0000034316.V334128.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 4 X 4 X 3 X 2 4 DS0000034316.V334128.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations There should be enough staff to deal with the assessed needs of residents at all times. Criminal record disclosure information may be held as a list with the relevant details using guidance from the Commission’s website. 2 OP29 Additional references should be sought from previous employers where these are relevant to the post being offered. Written reference to any resident in supervision notes need to be identified using initials only so that personal information is protected and records comply with data protection legislation. 3 OP37 DS0000034316.V334128.R01.S.doc Version 5.2 Page 23 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 DS0000034316.V334128.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!