Inspection on 16/08/05 for Ashfields Care Home

This inspection was carried out on 16th August 2005.

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 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

Ashfields Care Home 27/11/09

Ashfields Care Home 19/07/09

Ashfields Care Home 21/05/08

Ashfields Care Home 23/05/07

Ashfields Care Home 24/05/06

Ashfields Care Home 13/12/05

Ashfields Care Home 22/02/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashfields Care Home 129 Prestbury Road Macclesfield Cheshire SK10 3DA Lead Inspector Joan Adam Announced 16 August 2005 9:00 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 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 F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ashfields Care Home Address 129 Prestbury Road Macclesfield Cheshire SK10 3DA 01625 617288 01625 434753 Telephone number Fax number Email 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 Mrs Samantha Jane Buxton Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) Both of places Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 39 service users in the category of OP (old age, not falling within any other category) 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 22 February 2005 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. Ashfield’s 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 F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced visit of the home took place over six and a half hours and was carried out as part of the yearly inspection process. A tour of the home was carried out and care records, fire records and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Before the day of the inspection comment cards for residents and their families were sent to the home. Eleven residents’ and ten relatives comment cards were returned completed to the inspector. Comment cards were also sent to GP’s and other health care professionals and four were returned, all with positive comments such as” Staff are always helpful and fully aware of clients progress and history” and “ As district nurses we find staff are friendly, and helpful and will assist us with anything, nothing is too much trouble for them.” A detailed pre-inspection questionnaire was completed by the manager. Residents and staff were spoken to during the inspection. The service history of the home and the previous inspection report were read in preparation for the inspection. Four of the staff on duty and nine residents were spoken with during the inspection. What the service does well: The atmosphere at the home is warm and welcoming. The residents living at the home said that their needs were met and that they liked living there. The staff working at Ashfields have been at the home for some time and are aware of the needs of the residents. Staff training takes place to ensure that staff are competent and confident to do their job. Residents said that the meals are good and that they had plenty to eat. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 6 Residents at the home can be confident that their health care needs are being met to a good standard. Bedrooms are well personalised with the residents’ own furniture, ornaments and pictures. Residents said that they liked to “have their own things around them.” Completed comment cards from relatives said “very welcoming staff” “ very professional and efficient at all times combining this with cheerfulness and good humour” “ very nice pleasant staff, the home is clean, light and very pleasant”. What has improved since the last inspection? What they could do better: One of the resident’s files looked at did not have a care plan in place to guide the staff so that they can fully meet the needs of the resident. A resident whose identified needs had changed had not been reassessed to enable them to be moved to a suitable care home where the changed needs could be more appropriately met. Senior staff should be reminded that all notifiable incidents must be reported to the CSCI office immediately and not wait until the manager returns from leave. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 7 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 F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 3,6 Assessment procedures before residents move into the home are thorough and allow family members to be part of the process of assessing needs. The home only admits those people whose needs are in keeping with the skills and knowledge of staff working within the home. EVIDENCE: Care plans of two residents recently admitted to the home contained detailed pre-admission assessments. They contained assessments of dependency levels, likes and dislikes of the residents and involvement of family members. These had been carried out by the marketing manager who visits the resident prior to their admission to the home. Residents spoken with confirmed this. They also said that they had visited the home and had a look round with their families before deciding if they wanted to live there. Supporting documentation was present in the residents’ files from social workers, hospital staff or other care homes if the resident had been transferred from other establishments. Ashfields does not provide intermediate care. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 Care plans in general at the home are detailed but one plan of care looked at did not address the changing care needs of the resident. Staff members working at the home are aware of the needs of the residents. EVIDENCE: Care plans for five residents were looked at. The care plans were detailed and residents that had been newly admitted had some additional documentation such as manual handling risk assessments and a Walsall pressure sore calculator (a document to measure the skin integrity of the resident). Care plans identified problems such as personal care, promotion of independence and self worth, Diabetes, (which documents the involvement of district nurses) poor appetite. The two residents that were admitted with poor appetite have been weighed on a monthly basis and have gained weight steadily since admission. Risk assessments were in place for smoking, falls and wandering at night. These had been signed by the residents. All care plans had detailed reviews on Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 11 a monthly 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. Residents spoken with said that they could choose what they would like to do and where they would like to spend their day. The residents said, “ All the staff are lovely” “You can have a good laugh with the staff which is important”” You can stay in bed until late if you want to “ The atmosphere at the home is good and there was friendly banter between the staff and residents. However, one plan of care had a risk assessment in place for aggression towards residents and staff. There was no care plan in place to guide the staff as to the action they should take in the event of the resident becoming aggressive. (See requirement 1) Incidents that had occurred had been documented in the daily report and incident reports were completed. Monthly reviews and evaluation had been documented. The resident had lived at the home for some time and in December 2003 the review stated that following a visit by a psychiatrist the residents medication was increased and if no improvement, the resident should be reassessed and a move to a more appropriate care home would be found. The reviews continue to document aggressive behaviour from January 2004 to the present date, however the home had not acted upon the advice given in December 2003 until 16th August 2005. CPN and GP involvement had been documented. (See requirement 2) Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14,15 Residents at Ashfields are able to choose how they spend their day. The residents enjoy a good and varied choice of wholesome and well presented meals. EVIDENCE: An activities co-ordinator is employed at the home and a list of activities was displayed in the entrance hall. Activities such as beetle drive, bingo, card games, darts, manicures and flower arranging. There is a barge trip on a canal boat organised for September and some residents said that they were looking forward to the trip. A hairdresser visits the home twice weekly and entertainers are booked each month. Residents spoken with said that they could make choices as to how and where they spend their day. Two residents who smoke said that although for safety reasons the staff look after their cigarettes they never have to wait long for a smoke. Residents said that they can stay in their own rooms if they wish and some residents were seen to go to their bedrooms to watch TV after lunch. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 13 Comments such as “ You can do as you like,” “ Can’t fault the place” “ Staff are always pleasant” “ You can join in the activities if you like “ were made by the residents at Ashfields. The home has a varied menu on offer and resident’s comments about the food were positive. “The food is great “ “ Always plenty to eat” “ Can eat as much as you like, I had two puddings today” “ The food is lovely” Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints at the home are dealt with in accordance with the company’s complaints policy and residents and relatives know who to raise concerns with. EVIDENCE: There have been no complaints made to the home or to CSCI since the last inspection. Complaints recorded at the home have been dealt with under the company’s complaint procedure. A copy of the complaints procedure is available in the service users guide. Residents spoken with said that they had no complaints and that they were aware of who to speak to if they were unhappy about any aspects of the home. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 Residents live in a safe and well-maintained environment. Resident’s rooms suit their needs. The home was clean and did not have any unpleasant odours. EVIDENCE: The home has a planned maintenance programme in place. All corridors throughout the home have been decorated and new carpets have been laid in the corridors, main lounges, dining rooms and a number of bedrooms. New furniture has also been purchased for the lounges, dining room and some bedrooms. This has all taken place since the last inspection. The residents’ bedrooms are well personalised with their own furniture, ornaments and pictures. Residents said that they liked their bedrooms and “having their own things around them” Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 16 Residents spoken with said that they liked the different areas where they can sit and especially the downstairs landing area and the front door where they can “ watch the world go by” The home was clean and free from any unpleasant odours. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Residents’ benefit from a service that provides adequate staffing levels and well-informed and knowledgeable staff EVIDENCE: Duty rotas were seen and agreed staffing levels were being maintained. The staffing numbers at the home are adequate to meet the needs of the residents. Staff spoken with had a good relationship with the residents in their care and had knowledge of the needs and likes and dislikes of the residents. Staff said that they had received training in Moving & Handling, fire, first aid, food hygiene and NVQ level two in care. All training was recording in staff training files. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36,38 The management of the home maintain the safety of the residents living there. EVIDENCE: The manager at Ashfields is experienced and competent and has recently obtained an NVQ 4 in management. Formal supervision sessions for staff take place and supervision sessions are recorded in the training files. Residents living at the home said that their opinions are listened to. Residents’ choices are recorded in the individual plans of care. A senior manager visits the home on a monthly basis, unannounced. Areas checked on these visits are health and safety, property and equipment and Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 19 staffing issues. Discussion with residents and staff also takes place. The visits and any resulting actions are recorded with a copy of the report sent to CSCI Accidents are recorded appropriately. Safety certificates were in place for items such as hoists and passenger lifts. The fire log was checked and staff training had taken place in fire safety procedures. A notifiable incident had taken place and the home had not notified the CSCI office at the time. A notice was sent later when the manager had returned from holiday.( See recommendation 1) Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x 3 Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 21 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. 2. 3. Standard OP7 OP8 Regulation 15 14 Requirement A plan of care must be in place for all identified needs of the residents. The changing needs of residents must be met Timescale for action 30th september 2005 30th September 2005 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 38 Good Practice Recommendations All senior staff should be made aware of the need to complete regulation 37 notifications and send a copy to CSCI. Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 © 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 Ashfields Care Home F51 F01 S62416 Ashfields V236280 160805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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