Inspection on 25/06/07 for Ashfield Rest Home

This inspection was carried out on 25th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashfield Rest Home 19/12/08

Ashfield Rest Home 21/01/08

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashfield Rest Home 18 Windsor Square Exmouth Devon EX8 1JX Lead Inspector Caroline Rowland-Lapwood Key Unannounced Inspection 09:00 25th June 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 Ashfield Rest Home DS0000069112.V335023.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 Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashfield Rest Home Address 18 Windsor Square Exmouth Devon EX8 1JX 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) 01395 264503 01395 275652 South West Residential Homes Ltd Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (25) Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Total number of service users must not exceed 25 Date of last inspection 13/06/06 Brief Description of the Service: Ashfield is a residential home providing personal care for up to 25 older people who may have dementia or physical disability. It is situated in a quiet residential area of Exmouth approximately half a mile from the town centre. Accommodation is over 3 floors, with a stair lift between the ground and upper floors. All rooms are single occupancy. There is a central courtyard area and small front garden. Steps lead up to the front door but there is a level access through a side door. Information received from the home in June 2007 indicates that the current fees are £300-£375 weekly. Services not included in this fee are hairdressing, chiropody, papers and magazines and incontinence pads. CSCI Inspection reports are available upon request. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mr Alan Beale bought Ashfield in January 2007. He is an experienced care homeowner. This unannounced inspection took place as part of the normal programme of inspection. The site visit began at 09:00am and finished at 16:30pm on the 25th June. During that time we spent time talking with people living at the home, with staff and the manager. During this time we case tracked 3 people, which helps us to understand the experiences of people using the service by looking at how their needs are met. A number of other people at the home were met and spoke with at length during the course of the day. There were 22 people living at the home. We also spent time observing the care and attention given to the people living there by staff. Prior to the inspection surveys were sent to 7 people using the service; 6 were returned. Surveys were also sent to 8 staff members; 4 were returned. Eight surveys were sent to health and social care professionals and G.P.s; two were returned. Records relating to recruitment, training, health and safety and maintenance were looked at and a tour of the premises was taken. The manager had completed and returned a pre-inspection questionnaire before the inspection visit. What the service does well: The home has good procedures in place to carefully assess any prospective people before they move in, therefore ensuring that the home is suitable and will meet their needs. People said they “always” or “usually” receive the care and support they need. People said the staff are, “wonderful”,“ very good” and “ work hard”. Families and friends are encouraged to visit regularly and there are no restrictions on visiting times. People make choices in their daily lives, for example choosing what clothes to wear, what time to get up and go to bed and where to eat their meals. The majority of people were happy with the quality and variety of food provided at the home. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 6 Complaints received from relatives are dealt with efficiently and the manager views this system positively as a way of improving the quality of the services provided. People are protected from abuse through the training of staff in safeguarding vulnerable adults. The home has good systems in place to safeguard residents’ cash and valuables. What has improved since the last inspection? What they could do better: The people living at the home do not have their care planned in a way that coordinates their care or which ensures that consistently high standards of care can be delivered. In addition, further improvements are needed to meet their social needs, particularly in relation to meeting the needs of those people with communication difficulties such as dementia. Aspects of the management of medicines must be addressed so that practices are safe and people’s wellbeing is assured The activities at the home are very limited. Outside entertainers visit the home but very little happens in the home on a daily basis. Particular consideration should be given to stimulating and meaningful activities for people with dementia to ensure that individual preferences can be met. The building both internally and externally is in need of repair, renewal and decoration. The equipment in the laundry is not working to a satisfactory standard. Staff are not employed in sufficient numbers to ensure the home is clean in all areas. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 7 Staff are receiving training in most basic areas, however they should receive appropriate and sufficient training to develop their skills further. A number of safety issues are placing people at risk. These include infection control issues, the position of the make shift laundry, poorly maintained equipment, staff not receiving fire training, fire doors being wedged open and the use of freestanding electric heaters. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 8 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 Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 9 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 Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 10 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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personalised needs assessment means that people’s needs are identified and planned for before they move into the home. People have enough information about the home before they move in which helps them make an informed choice about whether the service is right for them. The home does not provide intermediate care EVIDENCE: In order to help people to make a decision about where they live, they are, where possible, invited to come and look around the home. Before moving in to the home the individual has their needs assessed to ensure that the home can meet their needs. Information is gathered from Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 11 them, their family, and health and social care professionals. The manager confirmed that she has visited people prior to them visiting the home. Pre assessment documentation was seen to support this. The staff described how each new person being admitted to the home is made welcome and helped to settle in. Staff say they have enough information about each new person moving into the home and are prepared for their admission. In staff surveys all members of staff said they were always introduced to new people. One relative said “ I had lots of information given to me about the home before my relative decided to live there including a long talk with the manager when I visited”. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People who live at the home generally have their healthcare needs met. However the way that care is planned and delivered is not ensuring that people receive a consistently high standard of individualised care. The management of medication in the service places the people that live there at risk of harm. Staff and the management team promote residents’ privacy and dignity. EVIDENCE: Ashfield is under new ownership and management and as a result are updating the care plans. A few have been started but are not yet complete. We looked at three care plans and found that, in general, they do not provide individualised plans for care, do not reflect changing needs and demonstrate a Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 13 lack of understanding of care planning by some staff. Some had limited social histories but most had none, giving no sense of who the person is and of the life they have led before living at the home. One care plan recorded that one individual must be moved on an hourly basis to relieve pressure areas and fluids encouraged with a view to drinking 8001000 mls a day. This had been clearly written following a detailed assessment by the district nurse, however during the morning after being helped to wash, this person remained in a chair and was not moved, there was no record of how much fluid had been offered or taken. When discussing this with staff they were unaware of his needs in spite of been given a handover by staff at the beginning of the shift. Another care plan gives instructions on what a person with diabetes should eat and includes a scoring system of risk in relation to this. However there was no explanation as to how the score was made and was unclear as to what it actually meant. This care plan gave conflicting information as to whether this person was actually diabetic or not, one entry seen said “no longer diabetic” but when checking it was clear that they are diabetic, take daily medication and are on a sugar free diet. Another care plan contained information about a person having oxygen therapy although there is nothing else written about the associated needs or risks involved with this. In general, care plans contain assessments in relation to identifying moving and handling needs, nutritional needs, skin care needs and risk of falls. However, the care plans seen do not always record the actions to be taken to overcome the risks identified or do not record them in sufficient detail. Some risk assessments seen contradicted each other. For instance one said that the person was able to make the choice about using a free standing radiator in her room whilst another risk assessment was seen in the same care plan that stated that the individual was at risk of trips and was at risk of scalding due to partial sight. Other care plans identify mental health needs associated with dementia. However, they do not identify how these mental health changes affect the person or how the person communicates. There was no evidence to suggest that people were involved in the care planning process or participated in the review of their care. In surveys five people say that they “always” get the care and support they need and one said “usually”. One person said that the staff call the GP when they were unwell “ pretty quickly”. There is evidence in records of referrals being made and advice being sought from specialist agencies. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 14 In questionnaires healthcare professionals who have patients at this home say that staff always or usually seek advice and act upon it and that people’s health care needs are always or usually met by the service. Preventative healthcare is achieved through visits from/to for example the chiropodist and optician. The commission earlier this year received a complaint (March 2007). It was in relation to the previous manager not promptly getting medical attention for a person who had sustained an injury and was in pain. Systems are now in place to ensure this does not happen again, staff are clear of their responsibilities in relation to this. Medication is on the whole managed poorly at this home. They use a monitored dosage system and one member of staff is responsible for the ordering, receipt and return of medication. On the day of the inspection it was found that staff had begun to use the medication from the blister pack before finishing the old one. As a result when the senior staff member went to dispense the medication the pack was empty. One administration sheet seen had been hand written, not dated or signed and did not include the dose of the medication to be given. For example, Aspirin 75mg. PRN ( as required) medication was not signed for but just ticked with no indication of how many tablets had been given. Nor was there any instruction as to when to give medication or how much. Prescribed ointments are not being signed as being applied. The controlled drugs cupboard was broken. The controlled drugs register was incorrect; the amount of tablets did not tally with the record although staff had signed as “checked” for weeks. Staff were observed knocking on bedroom doors before entering and keeping bedroom and bathroom doors closed when personal care is being given indicating that they respect peoples’ rights to privacy and dignity. Staff were heard talking with the people that live there in a friendly yet respectful manner. People confirmed that most staff are friendly, kind and treat them as they wish to be treated. The home has a friendly atmosphere and there was laughter and chatting in the lounge and dining room during the day. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people that live in the home cannot be assured that their interests or choices will be taken into account or that they can participate in meaningful activities. People benefit from the good relationships the home has developed with their relatives and representatives. People enjoy a balanced diet which takes into account their individual likes and dislikes. EVIDENCE: Some people said there were “sometimes” activities on offer. Not all are able or want to participate in organised activities and it is less clear how meaningful social engagement is achieved with them. Several people told us that they would enjoy being able to go out more. Visiting entertainers come to the home once a week. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 16 People were observed sitting for long periods of time on their own. Staff interacted with them when in the lounge when they could; some were able to talk with each other. Able people are supported to make decisions about their daily lives. Several were seen undertaking their own hobbies including knitting and reading. On the day of the inspection one person was going out to a family celebration, the staff had helped them get ready to go and made then feel very special by giving them cards and warm wishes. Staff do not always ensure that less able people are offered the same opportunities for choice of activity, for example for those cared for in their bedrooms their preferred choice of leisure was not always considered -whether it is listening to music or television to be left peacefully. One person who was unable to walk had the radio on, which was out of her reach, tuned to a pop music station. There was no evidence in her care plan to suggest she liked this and when asked she said it was a “din”. Families and friends are encouraged to visit regularly and there are no restrictions on visiting times. Some people make choices in their daily lives, for example choosing what clothes to wear, what time to get up and go to bed and where to eat their meals. Several people confirmed that they can have a “lie in” when they want and choose when they go to bed. The menu is quite varied. Some comments made about the food included: “generally very good” and “very nice”, with the exception of the few days prior to the inspection whereby a temporary chef had been employed and many people said that it had been of a poor quality and there had not been enough of it. This had been addressed and on the day of the inspection the meal was appetising, hot and of adequate quantity. Specialist diets are provided if required so that health care needs can be met. Some people eat in the attractively laid dining room; some choose a tray in their own room. The main meal of the day is fixed although alternatives are offered if it is not to the individuals liking. Staff ask people in the morning what they would like for their lunch that day. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that people’s views are listened to and acted upon. People feel safe and well cared for. Staff knowledge in relation to adult protection is good ensuring people are safeguarded from abuse. EVIDENCE: Two complaints were received by the commission, which the home were asked to investigate. The home investigated fully within the timescale of 28 days and both complaints were substantiated. Following this action was taken to ensure practice was improved The complaints policy is given to all people living in the home. In surveys respondents say they always know who to speak to if they are not happy and know how to make a complaint. People say they feel safe and are comfortable in the company of staff. The majority of staff have now received training in safeguarding adults and those spoken with demonstrate a good knowledge of this. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 18 Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 19 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): 19,25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst maintenance in some areas of the home was found to be good, the quality of decoration, furniture and fittings in some bedrooms is poor. The home is generally clean and fresh but some areas were in need of cleaning. The laundry facilities are not working to a satisfactory standard, this could put people at risk of infection. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 20 EVIDENCE: Mr Beale bought the home in January 2007. At that time the decoration and maintenance of all areas of the home were poor. The new owners have started to improve the décor by refurbishing and decorating some bedrooms. Most areas throughout the home are looking tired and in need of modernisation. The communal areas are decorated to a satisfactory standard. A programme of refurbishment and redecoration is in place and a handyman is about to be employed. Not all areas in the home were clean (see standard 27). The laundry is in the basement of the home. It is very small and cramped. We were told that recently there had been problems with the washing machine and tumble dryer and at times the staff had been taking washing home to do themselves, this poses an infection control risk. On the day of inspection a tumble dryer was being used in an unoccupied downstairs bedroom which was being used for storage, it had no vent attached and the fire door to this room was wedged open posing a considerable fire risk. We spoke to the manager about this and she explained that a repair had been done but that a new machine was needed and one had been ordered. She also explained that the laundry was going to be moved upstairs in the near future into a more satisfactory place and that in the meantime she would move the tumble dryer from downstairs to reduce any risks. The home does not employ a dedicated person to do the laundry; care staff looks after it as best they can. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff have the qualities and skills to provide residents with the support and care they need. However appropriate and sufficient training will help to develop their skills further. People benefit from satisfactory levels of care staff employed at the home but needs are not entirely met due to inadequate numbers of domestic staff. Recruitment systems are robust ensuring that people are protected. EVIDENCE: On the morning of inspection there were four care staff, a cook, and one domestic to care for twenty-two people. We were told that there would normally be three care staff on but there was one extra that day because of a mistake in the rota. Feedback from people found that staff were “usually” available when needed. During the inspection call bells were answered fairly quickly but at times people had to wait a little while. On the day of the inspection staff were busy, but seemed well organised. The domestic was extremely busy and more help was needed for her to sufficiently Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 22 clean all areas. Currently the home only has one domestic who works two days a week, the other domestic is off sick. Their duties include general cleaning of the house and one hour a day spent in the kitchen washing up. The areas that had been cleaned were tidy, clean and fresh, all communal areas were clean. However many areas were dirty with bins that had not been emptied and sinks that had not been washed. This is solely due to inadequate numbers of domestic staff. In surveys staff say they feel well supported and that they are not asked to care for anyone outside their area of expertise. Training for staff is beginning to improve. The new manager has developed a training matrix so that it is easy to recognise who needs training and when. Most staff have had up to date training in infection control, moving and handling and first aid, those that need updating are having training in the very near future. All staff are having updated training in the protection of vulnerable adults in the first week of July. Most staff have not had any training in caring for people with dementia, this would benefit many of the people living at the home so that their care needs can be understood and well met. The home employs staff from overseas; these staff are checked appropriately before they commence work. The home operates a good recruitment procedure that clearly highlights the processes to be followed. Three staff recruitment files were looked at during the visit. The documentation was consistent with evidence of a safe and robust recruitment process being carried out before a person is employed at the home. Previously induction training was never completed. The new manager has addressed this and has systems in place to ensure all new staff undergo a period of training when they start working at the home to enable them to get to know the people living at the home, the philosophy of care, safety procedures, all procedures and the general layout of the home. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 23 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 & 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents, relatives and staff benefit from the friendly and open management at the home. Systems are in place to ensure that residents’ personal monies are correctly managed. Several aspects of health & safety are not managed satisfactorily and places people at risk. EVIDENCE: An experienced and suitably qualified manager manages this home; Chrissie Medway-Steele has experience in care management and has many Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 24 qualifications relevant to running a care home including the Registered Managers award, NVQ 2 & 3, and two certificates in management and social care. Mrs Medway-Steele is new in post and has not yet applied to be the registered manager. There is a good quality assurance system in place. This includes people living at the home, friends, relatives and health professionals’ satisfaction surveys. A satisfaction survey is about to be undertaken, the results of which will be analysed and actions taken where issues arise. It is planned that there will be monthly meetings for people living at the home and relatives beginning in the near future. We looked at the personal accounts of three people at the home. Each is kept securely in a locked space. Each account is kept separately and records and receipts are kept. Balances were checked and were found to be in order. Staff meetings are held on a monthly basis and the minutes of these meetings were seen. A range of servicing and maintenance records was seen at this inspection; all were satisfactory including the electrical periodic report and gas safety certificate. Fire safety equipment, for example fire extinguishers, had been regularly serviced and the fire log showed regular checks and maintenance on emergency lighting and fire alarm. However, records showed that mandatory fire training for staff had not been completed since May 2006 placing people that live in the home at risk. On a tour of the building several areas of concern were found. One upstairs window was jammed open; this made the first floor very cold. Some radiators were not working; others were not sufficient to keep the house warm. There are freestanding electric radiators being used in bedrooms and communal areas, which pose a fire risk. Fire doors were wedged open, including a room with a tumble dryer in. The bathroom on the first floor had been “condemned” by the manager due to a possible electrical problem. There is no other bathroom on this floor meaning that people on the first floor have to go downstairs to use the bathroom. The stair lift was working and in use however the footplate was hanging off although it had been previously repaired with black tape, clearly this was unsafe. Following this inspection we contacted the owner Mr Beale. We discussed all the areas of concern and he was fully aware of the need to improve and already has actively put methods in place to make significant improvements to Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 25 both the premises and staffing. He is committed to improvement and was agreeable to address all those areas identified. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 26 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 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 2 X X 2 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1)(2) Requirement Each person living at the care home must have a plan of care that identifies all their individual needs and which offers instructions for staff on how these needs should be met in a consistent way. You must ensure that each plan is reviewed with the individual, when possible, so that changing needs are identified and appropriate actions to be taken are recorded and their effects reviewed. (timescale of 30/7/06 not met) 2. OP9 13 (2) All medicines in the home must be administered, recorded and kept safely and securely at all times. This will ensure the safety of people living at the home. 31/07/07 Timescale for action 30/09/07 Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 28 3 OP12 16 (2) (m) (n) Each person must have their social needs and interests identified and you must make arrangements to enable these needs to be met. This is particularly important for those people with dementia. This will ensure that people can live a fulfilling life. 31/08/07 4 OP19 23 (2)d 5 OP25 23(2) (p) The home must be kept clean and reasonably decorated so that people living at the home have a pleasant place to live The home must be kept warm to ensure comfort for the people that live there. 31/08/07 31/07/07 6 OP26 23(2)(c) 7 8 OP26 18(1)(a) 23(4)(a) 23(4)(d) OP38 Equipment provided in the care 31/07/07 home must be in good working order so that people living at the home are kept safe at all times. This refers to the washing machines and tumble dryers in the laundry. The home must employ sufficient 31/08/07 domestic staff to ensure the home is kept clean at all times. Fire doors must not be wedged 31/08/07 open All staff must have training in fire prevention. This will ensure the people living at the home are safe from the risk of fire. Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 29 8 OP38 13(4)(a) Risk to people that live at the home must be identified and eliminated or reduced as far as possible. On this occasion this includes 1) The operation of all windows 2) Free standing radiators must be removed to reduce the risk of fire or accident. 3) The bathroom electrics must be repaired. 4) The stair lift must be repaired This is to ensure people are kept safe. 14/07/07 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 OP30 Good Practice Recommendations All staff should receive training in caring for people with dementia Ashfield Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Rest Home DS0000069112.V335023.R01.S.doc Version 5.2 Page 31 - 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. 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