This inspection was carried out on 6th 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.
CARE HOMES FOR OLDER PEOPLE
Ashfield Malton - North Yorkshire County Council Ashfield Malton Old Malton Road Malton North Yorkshire YO17 7EY Lead Inspector
Pauline O`Rourke Unannounced Inspection 10:00 6 February 2006
th 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 Malton - North Yorkshire County Council DS0000034316.V276742.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 Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 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) 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 Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Ashfield is a care home providing personal care and accommodation. It is registered for 34 older people, however due to the number of double rooms being used as single rooms a maximum of 31 service users 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 and service users can access the shops, the post office and other amenities easily. The home is an adapted property and is set in its own grounds. The grounds are well maintained and accessible to the service users. There is also a passenger lift. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection including preparation time took place over 8 hours. A tour of the building was conducted. A number of the service users records, staff records and records about the management of the home were inspected. Service users, staff and several relatives were spoken with What the service does well: 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 Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 6 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 Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 7 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): 6 EVIDENCE: Intermediate care is not provided at Ashfield. None of these standards were assessed at this inspection. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 8 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 and 10 The service users personal care needs are met and they are treated with respect by the staff. EVIDENCE: The care plans for three service users were seen and it is clear there has been an improvement in the standard of information kept. However, where an area of assistance has been identified it should contain the detail of the actual assistance required. So instead of ‘help with bathing’ it should identify what help is required. There was evidence that the plans are reviewed monthly. These reviews could be extended to include the accident records and the service users risk assessments. The service users spoken with said that the staff are respectful and courteous at all times. They know to knock on a bedroom door before entering and call them by their preferred name. The staff spoken with said that their induction training covered issues such as dignity and respect and this informed their practice. Observation of the interactions between the service users and staff at all times of the inspection was seen to be respectful. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 9 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): 14 and 15 The service users enjoy a varied and balanced diet and can maintain their own routines in the home. EVIDENCE: Service users spoken with during the inspection said that they could follow their own routine in the home, choose where to take their meals and where to sit in the home. Staff had a good knowledge of the likes/dislikes and routines of the service users and some of this information was held in the service user files. The kitchen area was examined and found to be clean and well maintained. Service users can have meals either served in their rooms or in the dining area, mealtimes are flexible and service users spoken to felt the food was good. The menus are planned between the cooks and the management team. The meals served on the day of the inspection were well presented and service users spoken with had enjoyed them. It is recommended that the cook be provided with training to formalise the experience she has. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 10 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): EVIDENCE: None of these standards were assessed at this time. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 11 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): EVIDENCE: None of these standards were assessed at this time. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 12 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 and 30. Well-trained staff meets the service users needs. EVIDENCE: The rotas show that the staffing levels are currently sufficient to meet the needs of the service users. Service users spoken with said that the staff can take time with them and do provide social activities. Staff spoken with felt that at this time the staffing levels are appropriate. There are currently 10 staff that have completed their National Vocational Qualification level 2,whilst a further 6 are in the process of completing it. This means that during this year the home will exceed the required 50 of staff with a National Vocational Qualification Other training is provided to staff and covers such topics as back care, first aid, fire awareness, food hygiene, safe handling of medicines, dementia awareness induction training. Four staff files were seen and three of them contained the information as required by the Care Homes Regulations 2001. However information was not properly filed and so unavailable during the inspection. The information requested was found after the completion of the inspection. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 13 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 and 33. The service users benefit from a competent manager who monitors the quality of the service they receive. EVIDENCE: The registered manager has achieved the registered managers award and also has a National Vocational qualification level 4 in management. She is responsible only for Ashfield and receives monthly supervision from her line manager. Service users spoken with said that she was approachable and if they had any problems they would not hesitate in going to see her. Staff also said that they could speak to her at any time and when on duty she was always available to them. North Yorkshire has introduced a quality assurance system that involves the home checking the service it provides against the National Minimum Standards for Older People. Other information used in this process comes from the service user meetings, a questionnaire sent to relatives and friends of Ashfield, staff and management meetings. This information is used to develop the service provided at Ashfield.
Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 14 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X X Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 15 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. 2 Refer to Standard OP7 OP15 Good Practice Recommendations It is recommended that the promotion of independence plans contain more detail about the help required by the service users. It is recommended that the cook have some formal training to compliment the experience she has in catering. Ashfield Malton - North Yorkshire County Council DS0000034316.V276742.R01.S.doc Version 5.1 Page 16 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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