CARE HOMES FOR OLDER PEOPLE
Ashfields Care Home Ashfields 129 Prestbury Road Macclesfield Cheshire SK10 3DA Lead Inspector
Joan Adam Unannounced Inspection 13th December 2005 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 Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 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. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ashfields Care Home Address Ashfields 129 Prestbury Road Macclesfield Cheshire SK10 3DA 01625 617288 01625 434753 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) Winnie Care (Macclesfield) Ltd Samantha Jane Buxton Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. This home is registered for a maximum of 39 service users in the category of OP (old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 16th August 2005 Date of last inspection Brief Description of the Service: Ashfields is a privately owned care home located close to Macclesfield town centre. There are a variety of shops, a church and other facilities nearby. Ashfields is a three - storey building and residents are accommodated on all floors. Access between floors is via a shaft lift or the stairs. Residents accommodation currently consists of 39 single rooms, 24 of which have ensuite facilities. Included in these numbers are five flats which are in the grounds of the home, these are linked to the main building via an emergency call system. Service users living in the flats are more independent than those accommodated in the main building. There is a lounge, conservatory and a separate dining room available for service users. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over six hours and was carried out as part of the yearly inspection process. Care records, fire records, staff personnel and training files and medication records were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Eight residents, four visitors and four staff members were spoken with during the inspection. What the service does well: What has improved since the last inspection?
A programme of on-going redecoration continues at the home. The emergency lights have been upgraded to improve the safety of the residents. The management of the home has been improved by giving the manager more super-numery hours and a new computer system. The manager has completed
Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 6 the registered managers award and more than fifty per cent of care staff have achieved NVQ level two in care in line with the required standard. 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. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 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 Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This standard was assessed and fully met at the last inspection. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 9 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): 7,9,10 Care plans in general at the home are detailed and have a good standard of daily recording but one plan of care looked at did not address the care needs of the resident. Medication is being properly managed to protect the residents living at the home. Residents are treated with dignity and respect. EVIDENCE: Care plans for five residents were looked at. Care plans were detailed and identified problems such as personal care, promotion of independence, continence and specialist diets. Residents that have involvement from district nurses have visits and treatments documented. Manual handling risk assessments and a Walsall pressure sore calculator (a document to measure the skin integrity of the resident) are in place. Risk assessments were in place for smoking, falls and wandering at night. The residents had signed these. All care plans had detailed reviews on a monthly
Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 10 basis or if their needs changed. Visits by GPs, district nurses and nurse assessors, had been entered in to the care plan. Resident’s choices were entered in the care plan such as times of getting up and going to bed, types of food and whether they liked to stay in their own bedrooms. The daily recording was detailed and concise giving a good picture of how the residents spend their day. However, one resident that had recently been admitted to the home had a pre-admission assessment in place stating that the resident should be weighed on admission as they have a poor appetite. The resident had not as yet been weighed. The daily recording is good but the dietary intake of the resident had not been documented. Medication recording, management and storage were inspected. All medication administration records were completed correctly and medicines were stored securely. Residents spoken with said that they liked living at Ashfields and that staff treat them with respect. They said that staff always knocked on their bedroom doors before entering. One said “ the staff are always helpful but if I can do it myself they wait patiently for me until I finish” Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 11 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): 13 Relatives are welcome at any time and residents have contact with the local community in which they live. EVIDENCE: Visiting at the home is open and relatives were seen to come and go during the day. One resident was going for their daily walk in the garden, one resident was going shopping with a friend and one resident was going out for a pub lunch with their daughter. Two visitors spoken with said that they were always made welcome and if they were at the home during mealtimes they were always invited to eat with their relative. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 12 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): 18 The policies, procedures and management at the home protect the residents from abuse. EVIDENCE: A policy on the protection of vulnerable adults is in place and the home has an up-dated copy of the No Secrets guidance issued by the Department of Health. Staff have received training in adult protection in September 2005 and this was recorded in the staff training files. The induction programme at the home has a section on types of abuse and how to deal with this. Staff spoken with were aware of the policy on adult protection. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 13 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): 22,26 Residents have equipment to enable them to remain independent. The home is clean and free from odours. EVIDENCE: The home has equipment to enable the residents to maintain their independence such as grab rails, raised toilet seats and bath hoists. Since the last inspection the emergency lights have been upgraded at the home. There is on-going decoration of bedrooms. The home was clean and free from odours. Residents said that “ The staff are always cleaning” Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 14 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): 29 The recruitment procedures at the home are robust to ensure residents safety. EVIDENCE: The records of four recently appointed staff contained all appropriate checks prior to employment such as two written references, one of which was from a previous employer, enhanced checks with the Criminal Records Bureau and Protection of Vulnerable Adults and a health record. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 15 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): 33,34. Clear individual financial records are in place for all residents living at Ashfields. The home is run in the best interests of the residents. EVIDENCE: Clear individual financial records are in place for all residents living at Ashfields. Residents who live at the home feel that their opinions are listened to and that they can make choices as to how they spend their time. The fire log was checked and staff training in fire safety has taken place and was recorded. A new computer system has been installed to enable the management of the home to be improved. Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 16 Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X 3 X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 x X X X Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 18 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. 1. Standard OP7 Regulation 15 Requirement A plan of care must be in place for all identified needs of the residents. Timescale for action 10/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashfields Care Home DS0000062416.V273191.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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