Inspection on 12/05/08 for Ashfield Residential Care Home

This inspection was carried out on 12th May 2008.

CSCI found this care home to be providing an Excellent service.

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

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Ashfield Residential Care Home 23-25 Castle Road North Finchley London N12 9EE Lead Inspector Duncan Paterson Key Unannounced Inspection 12th & 13th May 2008 10:30 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 Residential Care Home DS0000071050.V362541.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 Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashfield Residential Care Home Address 23-25 Castle Road North Finchley London N12 9EE 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) 020 8445 4100 circa.care@btconnect.com Circa Care Limited Catherine Lorraine Nolan Care Home 15 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (15) of places Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 15 N/A 2. Date of last inspection Brief Description of the Service: Ashfield Residential Care Home is a private care home run by Circa Care Limited. The care home was first registered in 2005 after a major refurbishment. In 2007 Circa Care took over the running of the home from the previous owners and Circa Care was registered by CSCI in November 2007. The registered manager, Mrs Catherine Nolan, was also the registered manager when the home was run by the previous owners. Mrs Nolan and her husband, Mr Walter Nolan, are directors of the company and are also the manager and deputy manager respectively. The home is registered for 15 older people within the categories of old age and dementia. The care home is purpose built providing 13 single bedrooms and one double bedroom. All bedrooms have en suite facilities There is a lounge at the front of the building and a large dining / lounge area to the rear. There is a large garden with plenty of space for residents to sit out. The home is very close to the shops and facilities of North Finchley. The stated aims of the service include the provision of a comfortable and happy care home that residents will enjoy living in with comfort, privacy and dignity. The fees are between £455 - £550 per week. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This key inspection took place on 12 and 13 May 2008. The inspection involved time at the home talking with residents, staff and the management team. A standard form, the Annual Quality Assurance Assessment (AQAA), was returned to CSCI by the manager. This was taken into consideration. Three resident’s care arrangements were looked at in detail using our case tracking method. The inspection also involved the assessment of a range of the home’s records, procedures and forms as well as observation and a tour of the premises. Questionnaires were received from many of the people living at the service as well as relatives, staff and a visiting health professional. The manager and deputy manager both assisted with the inspection. The deputy manager was present for the second day of the inspection and assisted with the inspection of staff recruitment, training and quality assurance. What the service does well: The management arrangements are well organised resulting in a home that runs smoothly and efficiently. The good standard of administration is a strength of the service. Senior staff have been involved in taking lead responsibility in areas such as medication and staff supervision. This works well with staff motivated and enabled to provide a good standard of care. Staff are experienced and able to bring skills from previous roles and relevant training. Some are qualified nurses for example. There have been varied and relevant training opportunities provided to staff. The physical standards are good with this modern, comfortable home well maintained and providing residents with a pleasant place to live. There are efficient management initiatives in place that run well. The detailed quality assurance arrangements are an example of this. The managers and staff have created a calm environment with residents enabled to have familiar and unhurried routines of daily living. Mealtimes, which are an example of this, are managed well and appreciated by residents. Feedback from relatives, residents and staff confirm that there are many positive features to the service. For example, one relative said that staff were, “very helpful, always around to help”. Another described what was good about the service. “The whole care package.” Staff like working at the home. One Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 6 said, “There is a small, friendly atmosphere. I enjoy working here. I’d place my mother here”. 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. Ashfield Residential Care Home DS0000071050.V362541.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 Residential Care Home DS0000071050.V362541.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): 1 2 3 &4 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Well presented and accessible information is available to residents and visitors. The staff team provides good individual care for residents which will be enhanced by the development of dementia care initiatives. EVIDENCE: There is a range of information available providing people with details about the service. The statement of purpose has been updated to reflect the change in registration and there is a leaflet on display on a notice board in the hallway. This provides an introduction to the home and the services provided. The hall notice board provides other relevant information for residents and visitors. Case tracking methods were followed in order to look in detail at the care provided to three of the residents. This included looking at the assessment information obtained. Many of the people using the service are funded by local authorities and there are local authority assessments available. I saw examples of these and they provided detailed background information about Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 9 residents and their needs. These assessments were backed up by assessments carried out internally at this home. The assessments provided comprehensive information on which to plan and provide relevant care. There was positive feedback about the service from relatives as well as staff. For example, one relative said, “they are very easy going and let people do what they want while being safe and cared for”. Positive comments were also made by staff. The following was typical. “The home provides the best quality of caring and support for service users. People are treated with respect and dignity”. My observations were of staff working efficiently, respectfully and patiently with residents. I identified that there were positive features about the service which resulted in good outcomes for residents. These included the management arrangements which are discussed later in the report. There is also some good practice relating to dementia care but also the need to develop this. Details are provided in the next section. I discussed equalities and diversity initiatives with the management team and staff. There is some good practice in this area. The management team and staff clearly know the residents very well and have good links with relatives. This was evidenced through staff knowledge of people’s needs as well as the positive comments received from relatives in the surveys. The staff are therefore in a good position in order to provide individualised care. An example was given of how an Italian speaking member of staff was able to converse with a resident in her first language, although the resident also speaks English. I noticed that the home’s menu included the serving of Italian food at times. The AQAA stated that one of the changes planned to promote equality and diversity was to continue to actively seek feedback from all stakeholders. This has been successful so far and the management team are building useful links with other professionals. I was shown a contract for one of the residents. The deputy manager explained that this was a typical example and of the contracts in use. It provided clear details about payments and reasons why the service may be terminated. Ashfield Residential Care Home DS0000071050.V362541.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 &10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The managers and staff have been able to create a service that respects and promotes people’s dignity and privacy. There are good relations between all parties. The clear care planning and efficient staff communication can be improved through a review of care planning objectives. EVIDENCE: I used the case tracking method to look in detail at the care provided to three people. This involved inspecting the care plans, speaking with the residents as well as staff and, where possible, with relatives. The care plans are detailed and clearly set out each person’s needs. The care plans are reviewed monthly and there was input from the staff key workers who compiled notes of their involvement. Significant events were recorded when required. A number of residents are diagnosed with dementia and others have levels of cognitive impairment. I noted that work had been completed to address Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 11 people’s dementia care needs. For example, there were dementia care reviews on two of the case files I looked at and the manager explained that there were good links with GPs and other health care professionals. This had improved over the time the home had been running. The manager also told me that a member of the senior staff was currently undertaking a project to place on residents’ bedroom doors familiar items such as photos or personal momentos to assist recognition of their bedrooms. All this provides an excellent base from which to provide care. However, development of the dementia care arrangements at the home is needed so that residents can benefit even more from this service. For example, staff need specific dementia care training and it may be worthwhile for the management team to appoint a senior care worker to take responsibility for dementia care. The care planning arrangements also need a review to include more detail about dementia care needs and how they will be met. Staff were familiar with the care plans and ways of working with residents. One staff member, responding to the survey said, “the service is provided to the care plan. Any changes are made known to staff in handovers and on the notice board”. I identified that there was good and effective communication amongst the staff team. Both the managers and staff told me this and I observed the managers and staff working effectively together. The relatively small size of the home helps with this. I saw detailed health care records in respect of the residents. For example, there was a section where residents’ meetings with health care professionals were recorded. Weight records are kept each month and there are records kept of district nurse involvement, where relevant. I inspected the medication storage and administration records with a member of staff who has been given responsibility for medication. The Boots system is used which allow medication to be held in a blister pack for each occasion throughout the day it must be given. The member of staff responsible for medication had a good knowledge of each resident and the medication prescribed and had been involved in providing training for other staff. The records were clear and the storage arrangements were also well ordered with a separate storage space for any controlled drugs that might be in use. There were none in use during the inspection. I received some positive feedback about resident’s privacy and dignity. From the surveys received there was consensus that the service was doing well in respecting people’s privacy and dignity. For example, a health care professional said that the service was good at, “respecting resident’s dignity well. They work well with relatives”. A relative said that, “They tolerate and look after everyone in the same way.” Residents told me that they liked the staff and felt comfortable at the home. Ashfield Residential Care Home DS0000071050.V362541.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 & 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a relaxed friendly atmosphere at the home with residents given calm daily routines and opportunities for activities. Food provision is good with mealtimes relaxed and menus varied. EVIDENCE: There are a number of ways in which the managers and staff have worked towards providing residents with a suitable lifestyle and a sufficient and varied level of activities. A relaxed routine has been established where good use has been made of the opportunities provided by the physical standards at the home. For example, there are two communal rooms as well as a pleasant and accessible garden area. On the days of the inspection I saw that residents used all of these areas and I spoke with people in each area. There was plenty of space for residents who are more active and like to walk around the home and garden. Staff were also always around and assisting residents where needed. I observed staff working individually with residents including talking and playing games with them. Staff know the residents well. I also observed mealtimes. Residents eat in the dining room, usually at small tables for three Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 13 to four people. There was a friendly and unhurried atmosphere with staff assisting patiently when needed. One relative responding to the survey raised a point about religion and the fact that their relative had been regularly attending church before moving to the home and they would like that to continue. In addition, a member of staff told me that they did not take people out of the home as much as they would like. I was aware that outings did take place as staff told me. However, there was also feedback from health care professional that an improvement to the service could come about by offering more exercise to residents. These are areas that the management team can develop. There were positive comments from relatives about the visiting arrangements. One relative replying to the survey said, “They are always very friendly and welcome visitors at all times.” I spoke with a relative during the inspection and he told me that he was free to visit whenever he wished and that he was always made welcome. I observed the serving of lunch on the first day of the inspection and I spoke with the chef. The dining room is spacious and bright and provides a pleasant dining space for residents. Staff were helping residents to eat where necessary and some residents were eating separately in the lounge space. The meal was fish and fresh vegetables with rice pudding for dessert. There was a choice if desired. I noted from the menu that the meals served were traditional such as shepherds pie and beef stew but that the meals also included penne bolognaise. There were positive comments about the food from relatives and staff. One relative said that, “The food is varied and wholesome and caters for every taste”. And a staff member said that, “The service gives of it’s best in terms of residents’ food. People’s dietary needs and religion are kept in mind”. I was shown a certificate from Barnet Council entitled, “Good food safety management. High standard of compliance with food safety legislation”. Four stars had been awarded to the home in this food safety inspection, which was carried out on 19 February 2008. Ashfield Residential Care Home DS0000071050.V362541.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 & 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaint and safeguarding systems are well organised with staff knowledgeable and managers making available a range of relevant information. The safeguarding system can be developed, therefore offering greater safety for residents, through more staff receiving formal safeguarding training. EVIDENCE: There is a clear complaints policy and procedure as well as details on display as to how people can complain. I was shown the complaints records by the management team. No complaints have been made since the home opened and therefore none since the change in registration in 2007. I looked at the safeguarding systems in operation in detail as this inspection. The findings are to be used to contribute to current national safeguarding work CSCI is doing. All key inspections carried out between 5 and 16 May 2008 are being used in this way. This involved me in speaking to the management team, staff and residents about safeguarding matters, looking at staff training and recruitment as well as looking at the home’s safeguarding policy. The manager and staff were knowledgeable about safeguarding matters including definitions of abuse. They were all aware of the home’s policy and what to do in response to an incident or allegation of abuse. There have been no incidents of abuse since the home opened. The policy is reasonably detailed Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 15 and provides staff with an overview of how to respond. There are a number of additional documents that the management team make available to staff via the notice board and a section of the office which has relevant documents and policies on display for staff. These include literature about safeguarding including details from Help The Aged. Not all the staff have received formal training on safeguarding although safeguarding is covered in the induction and there is written material available as well as from the internet. The deputy manager said that training has been arranged for staff, usually from Barnet Council, and that more training will be offered. Meanwhile he undertook to conduct a review into staff’s training in order to identify those staff who still required formal safeguarding training. It was only possible to discuss safeguarding with one resident. The others were not able to understand the question. The one resident told me that if there were concerns about personal safety then the first point of contact would be the manager. She said that she likes the home and, “the staff are nice”. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 16 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 20 21 22 23 24 25 & 26 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are very good physical standards which have been well maintained. Residents are provided with a comfortable, attractive home. EVIDENCE: The home opened in 2005 after a major refurbishment of the property. The two original houses on the site have been brought together into a converted modern, residential home. The interior has been carefully designed and extended to the rear to provide a pleasant, attractive home with a spacious feel. There are bedrooms on the ground, first and second floor which are all served by a shaft lift. Communal rooms are available at the front of the home and the rear. The design assists residents with orientation. For example, there is a corridor connecting the front and rear of the home which has rooms off it and ends with the extended rear lounge / dining area, which provides access to the garden. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 17 The home has large grounds with space on both sides as well as a large rear well cultivated garden with space for residents to sit out. Buildings at the end of the garden house the laundry facilities and the refuse and clinical waste bins are stored tidily under cover to the left hand side of the home. There are thirteen single bedrooms and one shared bedroom. I was shown a number of bedrooms by the manager to get a sense of the home, as this was my first visit. I also spoke with one resident in private in her bedroom. All the rooms I saw were attractive, comfortably furnished, well kept and decorated. Some of the residents have brought in small items of furniture and others photos and memorabilia in order to personalise their rooms. The whole home was very well maintained. A clean, modern, comfortable home is the result. The new appearance of the home has been preserved and it offers pleasant facilities in which to live and work. There is a mobile hoist available although I was told that the admission of people with high levels of manual handling needs was not currently the practice. Having said that, I saw that a resident on the ground floor had been provided with a special bed which could be lowered and a larger bedroom. These had been provided to assist with mobility. I was advised that there had been an improvement in the resident’s mobility since moving to the home. The home is accessible to people who may need a wheelchair. There is a slope up to the front door which has been included in the overall design of the building. The central corridor allows residents to reach the ground floor facilities including the garden. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 18 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 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are experienced and competent, know the residents well and are able to provide a patient and caring service. Staff recruitment and training arrangements, which are good overall and provide residents with a safe service, will be improved by an audit of staff’s training. EVIDENCE: I was shown the staff rota. The typical arrangement is for there to be two care staff on duty throughout the day with a third on duty from 2-6pm. The manager or deputy manager is also on duty during the day. The cook is on duty from 8am to 2pm. There are two waking staff at night. This staffing arrangement is currently acceptable but will need review at regular times so that sufficient staff continue to be provided for the needs of residents. As described above, the management team operate a system where senior staff take on lead responsibility for certain parts of the service such as medication and quality assurance. One of the senior staff members has also been enrolled on the Registered Managers award. The senior team of staff, as well as others at the home, are qualified and experienced with a number having worked previously as nurses abroad. The AQAA returned to CSCI stated that 13 of the 14 staff have completed NVQ qualifications at level 2 or above. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 19 I inspected four staff files in order to assess the staff recruitment arrangements. Overall, recruitment is completed very well. One of the strengths of this service is the attention to detail and thoroughness of the administrative and management systems. There were references and CRB checks as well as other relevant recruitment information. However, I identified one problem in that a member of staff only had a CRB check from a previous employer rather than this employer. This was not the case for other staff and the deputy manager accepted that it was an oversight. He undertook to make immediate arrangements to obtain a CRB check and a POVAFirst check for the individual. I looked at staff training records. There was a staff training record audit displayed on the office wall which set out clearly the training that each member of staff had completed or was planned. I also spoke with care staff about the training they had received as well as cross checked with the training certificates kept on the staff files. Staff, in the main, have completed a great deal of relevant training including health and safety, nutrition and medication. I identified some gaps in the training staff had received. As already mentioned not all staff had received safeguarding adults training from an external source such as the local council. In addition, only one member of staff had completed dementia care training although the deputy manager had been active in arranging such training. Providing such training for staff will equip them for their role and provide benefits for the residents. I discussed the methods followed in checking whether staff had completed training. The deputy manager explained the process of appraisals where this was discussed as well an audit that had been carried out one year ago where staff were asked to detail on a form all the training they had received. The deputy manager undertook to repeat this process so that an up-to-date picture of staff training could be established. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 20 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 32 33 35 36 37 & 38 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management arrangements are well organised, efficient and carefully considered thereby contributing to an efficient service for residents. The quality assurance initiatives involve a range of people and result in action points which, when completed, will benefit residents. EVIDENCE: The manager is a qualified nurse and has many years experience working as a nurse and health visitor before managing the home. She has been the registered manager since the home opened in 2005 and now she operates the home in partnership with her husband who is the deputy manager and codirector. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 21 I identified that the home was being run in such a way that there were benefits for residents. For example, the manager and deputy manager work together well sharing both their working time at the home and the way they divide up different aspects of the running of the home. For example, the deputy manager took the lead for financial matters and staff recruitment whereas the manager took responsibility for care matters and working with relevant professionals such as health care professionals. Similarly, the management team had involved senior staff at the home in taking the lead for different aspects of care such as medication, staff supervision and quality assurance. Staff were also involved through the keyworking system where they took responsibility for individual residents. The AQQA returned to us gave details about improvements which had been made in the last 12 months. These centred around responding to requirements given at the last inspection as well as having introduced new procedures. Quality assurance was one example of this. The deputy manager showed me the quality assurance work. He explained that a wide view of quality assurance was taken so that matters such as staff records are also quality assured. The procedure followed is that of the National Care Homes Association and involves outcomes for people using the service. I was shown records where specific parts of the service, including food, visitors, the laundry and personal care, had all been looked at using this quality assurance method. I saw that action points had been drawn up following this exercise. I was also shown feedback which had been obtained from visiting professionals as well as relatives. The feedback I saw was positive about the service. I discussed the safekeeping of residents money with the deputy manager. He said that money was only looked after for two of the residents. The deputy manager showed me paperwork relating to the money looked after for the two residents. These were not all up-to-date but I could see the method followed. Both the residents were supported by local authorities and there were some issues relating to payment of arrears from the local authorities which the deputy manager was following up. Other than that, relatives usually took the lead for looking after residents’ money. There is a system where residents, or relatives on their behalf, pay a monthly contribution of £25 which covers all toiletries and other costs such as chiropody and hairdressing. This contribution is optional and residents are free to pay for these expenses on an as and when basis. I discussed the staff supervision arrangements with the deputy manager. He explained that the method followed is to have staff appraisals on a 6 monthly basis as well as frequent sessions with staff during the working day. The deputy manager said that staff were supervised on a regular basis but that such sessions were not always recorded. There are also regular team Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 22 meetings which are recorded. The supervision here may include day-to-day matters which are followed up by the manager or deputy manager. The system in operation is effective but will be enhanced through the demonstration that staff are being supervised on a basis more frequently than every six months. As described above, the overall record keeping and administration systems in operation are of a very good standard and are one of the strengths of the service. I was shown relevant paperwork and certificates relating to fire safety and drills and the servicing of the fire alarm and fire safety equipment. I was also shown certificates relating to the servicing of the home’s shaft lift and electricity and gas installations. These had all been carried out regularly and were available for inspection. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 23 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 3 3 3 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 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 3 3 4 Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19(1)(b) Sch 2 Requirement All information required by Schedule 2 of The Care Homes Regulations 2001 must be obtained in respect of staff before they are offered work at the home. This will ensure that staff are recruited safely before working with residents. Timescale for action 15/06/08 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 3 Refer to Standard OP7 OP30 OP36 Good Practice Recommendations Care plan objectives, including that of dementia care, should be reviewed so that it is clearer how the service will meet residents’ needs. Staff’s training needs should be reviewed to ensure that all staff have received formal safeguarding and dementia care training. The home’s records should demonstrate that staff have received supervision more frequently than six monthly intervals. Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Ashfield Residential Care Home DS0000071050.V362541.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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