Inspection on 23/05/07 for Ashfields Care Home

This inspection was carried out on 23rd May 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

Ashfields Care Home 27/11/09

Ashfields Care Home 19/07/09

Ashfields Care Home 21/05/08

Ashfields Care Home 24/05/06

Ashfields Care Home 13/12/05

Ashfields Care Home 16/08/05

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 Ashfields 129 Prestbury Road Macclesfield Cheshire SK10 3DA Lead Inspector Joan Adam Unannounced Inspection 10:00 23 /30th May 2007 rd 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.V333775.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. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 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 vacant post Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 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) 24th May 2006 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. The current scale of charges for the home are £343.34 to £455 for the flats, per week. This information was provided by the acting manager. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 23rd and 39th May 2007 and took nine hours. It was carried out by an inspector of the Commission The visit was just one part of the inspection. The home was not informed of the date the visit was to take place, but a few weeks prior to the visit the acting manager was asked to complete a questionnaire to provide the inspector with some information about the service. The acting manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. The acting manager was not at the home for these visits but a deputy manager was on duty. The inspector made a second visit to the home, as keys to the filing cabinet containing information required for the inspection were not available. Two residents and three relatives who completed a questionnaire made positive comments. Comments such as “the home looks after everybody very well” “happy family atmosphere ” were put on the questionnaires. What the service does well: What has improved since the last inspection? The home has an on going programme of refurbishment and redecoration and a number of bedrooms have been redecorated. New fridges and freezers have been purchased for the main kitchen to replace worn equipment. The home has recently compiled new menus using guidelines for the care and residential industry to improve the nutritional value of the food on offer. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 6 Residents spoken with said “ the food is good” “ the food is tasty and you get plenty” The home has been awarded a “Gold Award” for the kitchen by the environmental health officer. 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. Ashfields Care Home DS0000062416.V333775.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 Ashfields Care Home DS0000062416.V333775.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): 3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents needs are not always assessed before they move in to the home so that staff will know how to meet their needs. EVIDENCE: Three residents had recently been admitted to Ashfields. The assessment of these residents was looked at. The acting manager or another suitably qualified person carries out assessments. One resident had pre-admission documentation completed before they were admitted to the home by the area manager. This resident confirmed that they had been visited by the area manager before coming to live at the home. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 9 However, two of the residents’ pre-admission documentation was incomplete. One form had been dated the day the resident was admitted. These two residents could not confirm whether they had been visited by staff from the home prior to their admission. The home is not registered to take residents with intermediate care needs. Ashfields Care Home DS0000062416.V333775.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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recording of residents needs must improve to ensure that their health care needs can be adequately met. EVIDENCE: Care plans were looked at for four residents living at the home. One resident had a care plan in place which stated that they had a history of falls, however, there was no risk assessment in place regarding this to enable staff to maintain their safety whilst promoting their independence. One resident had a care plan in place stating that they had a weight loss problem, however, the resident had not been weighed and there was no evidence that the resident had been referred to a dietician. One resident had an evaluation of needs form completed, however, there were no care plans in place to enable staff at the home to be aware of and meet the residents’ needs. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 11 One resident had a care plan in place for loss of weight and their weight was being monitored on a monthly basis, however, there was no evidence that the resident had been referred to the dietician. Care plans that were in place had been reviewed on a monthly basis. A separate page was available for staff to list visits by health care professionals such as GP’s, district nurses, chiropodist, dieticians and nurse assessors. Visits were recorded for two of the residents care plans seen. Residents said that staff treated them with courtesy and respected their privacy. “ the staff are really nice” “ the staff know what I like” Observation of care practices demonstrated that care staff were sensitive to the diverse needs of residents. Medications were managed well and storage arrangements were satisfactory. The home used a monitored dosage system. Medication Administration Record Sheets were completed appropriately. One resident who self administered medication had a risk assessment in place. Ashfields Care Home DS0000062416.V333775.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a good quality of life with their choices respected. standard of catering is good. The EVIDENCE: There is an activities co-ordinator employed at the home and activities on offer are varied. These include beetle drives, bingo, card games, darts, flower arranging, tai chi sessions, movement to music and quizzes. Outside entertainers are regularly booked at the home. Local clergy visit on a regular basis to give Communion for residents who require this. Residents spoken with said” there is something to do most days” I enjoy the entertainment best” “ I don’t like to join in much but you are never made to feel awkward if you say no” One comment card received from a relative said ”Residents are encouraged to maintain hobbies and interests where possible.” Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 13 The spiritual needs of residents are met. There is a regular monthly service and residents are supported to attend church services in the community if they wish. The home has recently compiled new menus using guidelines for the care and residential industry to improve the nutritional value of the food on offer. Residents spoken with said “ the food is good” “ the food is tasty and you get plenty” The home has been awarded a “Gold Award” for the kitchen by the environmental health officer. Ashfields Care Home DS0000062416.V333775.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was no evidence to show that complaints are well managed. Residents are protected from possible abuse. EVIDENCE: The home has a complaints procedure in place and copies of this are in the service user guide and in the main entrance to the home. The information received from the acting manager prior to the visit stated that one complaint had been made to the home since the last inspection. On the day of the inspection the deputy manager on duty was unable to find the complaint log. Therefore it was not possible to see if the home had responded to the complaint correctly. The inspector made a second visit to the home but the file containing the recording of complaints could still not be found. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 15 Ashfields has policies and procedures relating to the protection of vulnerable adults and a copy of the government publication “No Secrets” about adult protection. Care staff undertake training in adult protection as part of their induction and also within NVQ training courses. Staff have also received POVA training in May 2006, however, the area manager stated that all staff were to have further training within the next few months. There have been two POVA issues at the home since March 2007 which have been referred to the appropriate authorities. Ashfields Care Home DS0000062416.V333775.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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well kept clean environment. EVIDENCE: Since the last inspection the roof has been repaired and the drains in the car park have been replaced. Some bedrooms have been redecorated as on going maintenance of the home. The corridor carpets have not as yet been replaced but are due to be changed as part of the capital expenditure for this year. Two new fridges have been purchased for the main kitchen area. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and skill mix are sufficient to meet the needs of the residents, the home’s recruitment practices and staff training protect residents living at Ashfields. EVIDENCE: There are enough staff on duty to ensure that the health and social care needs of residents are met. In conversation care staff demonstrated that they were knowledgeable about the care needs of residents. Many staff have worked at the home for a number of years, which provides stability and continuity. Several members of staff said that Ashfields offers a pleasant working environment. Most residents commented that staff were always available when needed. Information provided by the acting manager before the inspection indicated that 45 of care staff have achieved NVQ level 2 or above. The recruitment files of three new staff members were checked on a second vivit to the home. The keys to the filing cabinet were not avaviable on the first visit to enable the inspector to gain access to these files as part of the inspection process. The files contained all necessary information including a “POVA first” check which indicates that it is acceptable to employ staff under supervision until a full check is received from the Criminal Records Bureau. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 18 Domestic staff are employed in sufficient numbers to ensure that catering needs are met and the home is maintained in a clean and hygienic condition, free from unpleasant odours. Up-to-date staff training records are maintained for all staff. These confirm that a staff-training programme is in place. The staff training programme over the last 12 month period has included Fire Awareness, Emergency First Aid, Food Hygiene, Moving and Handling, Health and Safety, Boots drug foundation course, COSHH and care planning. Further training is planned in Moving and Handling, Fire Awareness, POVA and Medication Administration training. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 19 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. Improvements need to be made to ensure the health safety and welfare of residents is protected. EVIDENCE: There is an acting manager in post at the present time. She has not been registered with CSCI. The inspector had to return to the home for a second visit to gain access to all records relevant to the inspection process as staff did not have keys to the filing cabinet. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 20 The acting manager provided the CSCI with written information about the home. This indicated that facilities, installations and equipment had been serviced on a regular basis. Fire safety records demonstrated that fire equipment and installations are tested and serviced on a regular basis. Residents’ finances were looked at and these were recorded correctly, with receipts for items purchased on behalf of residents. Resident/relative and staff meetings have not been held since the acting manager has been in post. There was limited evidence of formal consultation between the home and residents, relatives and other stakeholders. The company has a quality monitoring system is in place, however, questionnaires had not been sent out for some time, therefore, the home was not gaining the views of residents living there. This was a requirement at the last inspection. One resident who had a history of falls had not had a risk assessment completed to enable staff to ensure that their safety was being met whilst promoting independence. One resident did not have a care plan in place to enable staff to know how to meet their needs. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 21 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14 (1)(a) Requirement The registered person must ensure that no resident is admitted to the care home before the full needs of the resident have been assessed to ensure that the home can fully meet their needs. The registered person must ensure that each resident has a care plan in place to enable staff to meet their needs. The registered person must ensure that residents are referred to health care professional for advice and treatment. The registered person must ensure that risk assessments are in place for identified risks to residents. The registered person must ensure that a system for reviewing the quality of care is implemented. ( Requirement of 31/07/06 not met.) Timescale for action 30/06/07 2 OP7 15(1) 30/06/07 3 OP7 13 (1)(b) 30/06/07 4 OP38 13(4)© 30/06/07 5 OP38 24 31/07/07 Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 OP28 Good Practice Recommendations The registered person should ensure that the carpets in the corridors should be replaced The registered person should ensure that 50 of staff members are qualified to NVQ level 2. Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Ashfields Care Home DS0000062416.V333775.R01.S.doc Version 5.2 Page 25 - 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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