Inspection on 24/05/06 for Ashfields Care Home

This inspection was carried out on 24th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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 Key Unannounced Inspection 24 May 2006 10:00 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.V287234.R01.S.doc Version 5.1 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.V287234.R01.S.doc Version 5.1 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.V287234.R01.S.doc Version 5.1 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 13th December 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. The current scale of charges for the home are £341.29 to £420 for the flats, per week. This information was provided by the manager. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 24th May 2006 as part of the Commission for Social Care Inspection annual inspection programme. The service history of the home and the previous inspection report were read in preparation for the inspection. The manager had provided a completed preinspection questionnaire. A tour of the building was conducted, including all communal areas and some bedrooms. Time was spent in conversation with the manager and a sample of records were inspected. Arrangements for medicines were inspected. Most of the staff on duty and a number of residents, relatives and a visiting nurse were also spoken with. What the service does well: Ashfields is well managed. It provides comfortable, well-equipped and nicely decorated accommodation. The home’s assessment and care planning processes are based on good practice. These involve the resident and their representatives in the continuing development of effective arrangements for care and support. Residents are able to choose from a number of activities and are assisted to visit the local shops and other places of interest. The vast majority of residents are satisfied with the standard of catering. Visiting relatives said they are made welcome at all times. Residents said that they are able to entertain their guests in private if they so choose and their visitors can stay for a meal by arrangement. Choice is offered with every meal, and likes, dislikes and special dietary needs are known and catered for. Staff are employed in appropriate numbers and work together as an effective team. They demonstrate a clear understanding of residents needs and enjoy good working relationships with visiting health and social care professionals. Proper recruitment procedures ensure the protection of residents Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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.V287234.R01.S.doc Version 5.1 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): 3 The quality rating for this outcome area is good. New residents have the information they need to make an informed choice about the home before they move in. They move in on the basis of a full assessment undertaken by competent persons. EVIDENCE: As part of the tracking system the pre-admission documentation of one new resident who had moved into the home in recent weeks was looked at. It contained assessments of dependency levels and likes and dislikes of the resident. Discussion with the resident confirmed that they had moved into the home in the knowledge that is suitable to meet their identified needs. The resident had moved in to the home from some distance away but said that they had been visited by the marketing manager for Ashfields and a social worker prior to the move and had been given adequate information to enable them to make the decision to move in to the home. The resident confirmed that they are staying at Ashfields on a trail basis. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 9 Documents confirming terms and conditions are made available to them and a copy is also available on the residents file. The home does not provide intermediate care therefore standard six was not looked at. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9and 10 The quality rating for this outcome area is adequate. Arrangements for care are confirmed in individual care plans that state how the residents’ needs are to be met. Contact is maintained with residents’ relatives and health and social care professionals and staff know what action to take when a resident is unwell. Medications are managed appropriately to maintain the safety of the residents. Residents are treated with respect and their views are valued and acted upon. EVIDENCE: Four care plans were seen as part of a case tracking exercise. These reflected the needs of each resident as identified in the assessment process and confirmed appropriate arrangements for the care of each person, including likes, dislikes and what the person can do for themselves. Care plans reflect maintaining independence for the resident. Visits by GPs, district nurses and nurse assessors, had been entered in to the care plan. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 11 Moving and handling assessments and appropriate risk assessments were in place on care plans looked at and these had been signed by the residents. The care plans had detailed evaluations which had taken place monthly. However, one care plan indicated that the resident had been admitted to the home for respite stay in April 2005 and no new care plans had been put in to place following the fact that the resident was now living at the home on a permanent basis to enable care staff to know what to do for this resident. One resident had sustained a fall and although an accident form had been completed there was no entry made in to the care plan. See requirement 1 Alterations had been made to some care plans however the staff member that had made the changes had not signed and dated the entry. See recommendation 1 Residents speak highly of the care staff team indicating satisfaction with the standard of care provided. They said the home’s staff are marvellous, they treat us with respect and they know how to respect our privacy. A medications check confirmed that medicines are administered, stored and recorded properly. Information provided by a visiting member of the rapid response team indicated that they are satisfied with the standard of care. Staff demonstrate a clear understanding of residents needs and make contact to discuss significant events. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15. The quality rating for this outcome area is good. Residents are able to make choices about their daily lives including taking part in a wide range of activities, so they can keep active and retain their interests. The quality of the food is very good. Alternative meals and special diets are available so that all service users have a varied and nutritious diet of food that they enjoy. EVIDENCE: Ashfields employs an activities co-ordinator and a list of activities was displayed in the entrance hall. Activities provided are varied and include beetle drive, bingo, card games, darts, manicures, quizzes and flower arranging. A hairdresser visits the home twice weekly and entertainers are booked each month. Trips are arranged to local shops and garden centres. Tia chia sessions have recently been added to the list of the activities on offer. Clothing sales take place on a regular basis to enable residents the opportunity to choose their own clothes and shoes. Local clergy attend on a regular basis to give Communion to residents who require this. Residents spoken with said that they can go out to church or arrangements can be made for clergy of their choice to come to the home. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 13 Residents spoken with said “there is always something going on” is yours whether to join in or not” “birthdays are made special.” “the choice Visiting relatives said they are made welcome at all times. Residents said that they are able to entertain their guests in private if they so choose and their visitors can stay for a meal by arrangement. One relative takes her mother home twice a week and said,” if she comes back late they always offer her something to eat.” One resident was going away for a few days with her family. Comments made by residents regarding the home were “ the home always has a good atmosphere” “the staff have a positive attitude and are very helpful” “ no one comes in to my room without knocking first” “ it is a lovely home with plenty to do and the staff look after me well.” All residents praised the Cooks and the standard of catering in the home. Special dietary needs are catered for and menus seen confirm that a varied and nutritious diet is on offer. The company is at present compiling new menus using guidelines for the care and residential industry to improve the nutritional value of the food on offer. The home manager has been involved and discussions are to take place with the residents regarding choice of foods. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 the following standard(s): The quality rating for this outcome area is good. 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. Staff members are aware regarding the protection of vulnerable adults and know how to safeguard residents. EVIDENCE: The home’s complaints procedure provides appropriate guidance and information as to how to make a complaint. There have been no complaints made to the home or to CSCI since the last inspection. This information was provided by the manager in the pre-inspection questionnaire and by looking at the complaints file. New staff employed at the home have an induction programme, which has a section on types of abuse and how to deal with this. Staff spoken with were aware of the policy on adult protection. An up-dated copy of the No Secrets guidance issued by the Department of Health is present in the home and a policy on the protection of vulnerable adults is in place. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 the following standard(s): 19,26 The quality rating for this outcome area is good. Residents live in well-maintained, comfortable, clean and hygienic accommodation with access to appropriate indoor and outdoor communal facilities. EVIDENCE: The home is well maintained with good quality furnishings and fittings. Decoration at the home is on going. All areas of the home seen were clean and free from unpleasant odours. Residents said the home is clean, homely and comfortable. New carpets have been ordered for the middle and top corridor of the home. A new set of scales has been purchased to enable residents who cannot use the bathroom scales to be weighed regularly. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 16 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): 27,28,29,30 The quality rating for this outcome area is good. Care staffing levels and skills are adequate to make sure that residents’ needs are met. EVIDENCE: Reading of staff rosters and discussion with residents, relatives and staff confirms that staff are employed in appropriate numbers and skill mix suitable for the well being of residents. The pre inspection questionnaire completed by the manager prior to the site visit states that the manager is working towards achieving a minimum ratio of 50 of staff members qualified to NVQ level 2 or equivalent. At the time of the inspection 46 of care staff had achieved the qualification. See recommendation 2 Recruitment records for two new members of staff were inspected. The staff files examined showed that two references and Criminal Records Bureau disclosures are in place for all staff. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 17 Records demonstrated that all care staff had received comprehensive training in areas such as moving and handling, food hygiene and fire safety within the last twelve months to ensure that they are competent to do their job. Staff spoken with confirmed that training had taken place. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 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): 31,33,35,38 The quality rating for this outcome area is adequate. The home has a competent and enthusiastic registered manager who demonstrates a commitment to her own training and development in order to protect residents and enhance their quality of life. The service needs to collect feedback regarding the quality of the care provided. Residents’ personal allowances are being handled appropriately. EVIDENCE: The registered manager is experienced and competent and has obtained an NVQ 4 in management. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 19 All of the residents spoken with are fully aware of who the manager is and they feel she is very helpful and kind. Another resident, when asked said that she could approach the manager if she had a problem and she knew something would be sorted out. The processes of managing the home are open and transparent. Residents are confident and speak openly about the home talking about the pros and cons of residential life. Residents’ personal allowances are being handled appropriately. Fire prevention procedures are reviewed on a weekly basis and the lift, fire equipment, and fire alarm systems are serviced at appropriate intervals. Regulation 26 visits are carried out by the regional manager and are reported to the Commission for Social Care Inspection, however, the home does not have a system for routinely monitoring the quality of care provided in the home, which seeks the views of residents and their relatives. See requirement 2 Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 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 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 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 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 3 X 3 X 3 X x 2 Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 21 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. 2 Standard OP7 OP38 Regulation 15 24 Requirement Plans of care must reflect the changing needs of the residents living at the home. The registered person must ensure that a system for reviewing the quality of care is implemented. Timescale for action 30/06/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 1 Refer to Standard OP7 OP28 Good Practice Recommendations All staff should sign and date care plan documentation following changes. The registered person should ensure that 50 of staff members are qualified to NVQ level 2. Ashfields Care Home DS0000062416.V287234.R01.S.doc Version 5.1 Page 22 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 © 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.V287234.R01.S.doc Version 5.1 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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