Inspection on 09/05/06 for Ashford Lodge Care Home

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Ashford Lodge Care Home 01/04/08

Ashford Lodge Care Home 04/05/07

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

CARE HOMES FOR OLDER PEOPLE Ashford Lodge Care Home 1 Gregory Street Ilkeston Derby DE7 8AE Lead Inspector Vanessa Davies Unannounced Inspection 9th May 2006 09:30 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 Ashford Lodge Care Home DS0000066561.V293211.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. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashford Lodge Care Home Address 1 Gregory Street Ilkeston Derby DE7 8AE 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) 0115 930 7650 0115 930 7650 Andrew David Carnachan Vacant Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Carpets highlighted at the site visit are to be replaced by 28th February 2007. The bathroom currently not used due to inaccessibility, will be converted to an accessible shower room by 28th February 2007. Date of last inspection Brief Description of the Service: Ashford Lodge is a large detached property adapted to meet the needs of 20 older people. It has 2 floors with bedrooms on both floors, the first floor is accessible by a passenger lift and stair lifts. There is a large conservatory, lounge and dining area, along with a smaller quiet lounge area. The home has an accessible garden area and parking for 2 – 3 cars. The home provides nursing care and has a registered nurse on duty 24 hours a day. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and the provider was available for the latter part. The manager had been dismissed the previous day and the provider was in the process of preparing to advertise for a new manager and to ensure appropriate cover in the absence of a manager. Although this report does appear to show a poor service, readers must recognise that the service has recently changed providers and the manager has been dismissed. The provider does have plans to improve the service and in doing so wants a suitable registered manager to move the home forward. What the service does well: What has improved since the last inspection? What they could do better: Assessments of need must be more detailed to ensure that the home is able to meet the needs of the residents. Care plans must address social needs of residents in addition to health needs. The provider must ensure that other professionals are involved with the residents, the deputy manager stated that they refer to other professionals as necessary, however there were 2 residents with pressure sores but no input from tissue viability nurses. The provider should ensure that the internal training discussed at the inspection is implemented, in order to address issues raised at the inspection. All homely remedies should be agreed with the GP prior to administration. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 6 The provider should ensure that there is an activity plan in place ensuring that it meets the expectations of the residents. Residents should be supported and made aware of there right to choose. Any changes to the menu should be documented. The complaints procedure and the adult protection policy both need to be reviewed to reflect changes. The home is currently without a Registered manager and this needs to be addressed. The provider did assure the inspector that he was dealing with it as a matter urgency. 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. Ashford Lodge Care Home DS0000066561.V293211.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 Ashford Lodge Care Home DS0000066561.V293211.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): 1,3,6 Quality in this outcome area is adequate. Lack of information within the assessments potentially prevents the home meeting the needs of the residents. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The provider is new to the service and is currently in the process of reviewing the Statement of Purpose to ensure it reflects the current service. 3 residents files were examined. All files had an assessment of need, however there was limited information available, in one case the was so little information that it was not possible to establish how the previous manager was able to state that the residents needs could be met. Care plans to address Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 9 nursing needs were available within the files, however there were no care plans within any files to address social needs. Assessments and care plans were discussed with the deputy manager and provider. The home does not offer intermediate care. Ashford Lodge Care Home DS0000066561.V293211.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): 7,8,9,10 Quality in this outcome area is adequate. Limited information within files and lack of input from relevant professionals potentially prevents staff from meeting the needs of the residents. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: As stated previously the care plans addressed the health needs of the residents but not the social needs. Residents have access to other professionals as necessary, the deputy manager stated that tissue viability nurses were involved as necessary, however 2 of the files examined had care plans and information regarding pressure sores but no evidence of information and advice from tissue viability nurses. The provider stated that social information was been gathered for all new residents and that relatives were involved with this information gathering. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 11 When speaking with residents they stated that there were not enough activities to do during the day, one stated that all there was to do was watch the TV. Medication is administered by registered nursing staff only. The medication policy details homely remedies and when to use, however there is no evidence of an agreement with the GP for this medication to be used without prescription. All of the residents spoken with stated that the staff treat them with respect. On the day of inspection the inspector asked to see a bedroom, the member of staff went to the bedroom knowing that there was a resident in bed and entered the room without knocking on the door and then preceded to speak about the resident whilst she was in bed. This was discussed with the provider who intends to address this with internal training. Ashford Lodge Care Home DS0000066561.V293211.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): 13,14,15 Quality in this outcome area is adequate. Valuable input from relatives ensures that they continue to be involved with their relative ensuring preferences and interests are met. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The residents spoken with stated that their relatives are always made to feel welcome and this was apparent on the day of inspection. It was evident in the files tracked that relatives are involved with the residents care and this was confirmed when speaking with the provider and the deputy manager. One resident spoken with stated that he was not aware of a choice of menu, if he was offered something he did not like he would leave it and not ask for an alternative, when the menus were examined they appeared to offer a balanced, healthy diet but no alternative was available. The cook did state that alternatives are offered but there was no record of this. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 13 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): 16,18 Quality in this outcome area is poor. Lack of up to date policies and procedures and staff training potentially puts residents at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The provider stated that he takes complaints very seriously. The complaints procedure is now out of date and refers to NCSC, this needs to be reviewed to include Social Services responsibility in the investigation of complaints. The home does keep a record of all complaints made. The home has a policy in place identifying abuse, it details the managers responsibilities, however it does not indicate the responsibility of staff and the joint working with Social Services. Staff training records did not evidence training of adult protection. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 14 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 Quality in this outcome area is adequate. Addressing the areas highlighted for improvement ensures that the residents live in a safe clean environment. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: There are areas for improvement within this section and these were highlighted at the site visit and conditions of registration were set to address these. Improvements have been agreed with the new provider and he does have a plan to address them. The home is very clean and tidy with no malodour. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 15 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): This section was not assessed on this occasion but will be addressed within the next report. EVIDENCE: Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is poor. The lack of a Registered Manager at the home potentially means that staff are not supported appropriately, therefore having a negative affect on the care provided. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: There is currently no Registered Manager at the home and it is being run by the new provider and the deputy manager. The provider assured the inspector that he was addressing the vacancy. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 N/A 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 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 2 3 Standard OP3 OP18 OP31 Regulation 14.1 Requirement Timescale for action 30/06/06 31/07/06 30/09/06 All of the needs of the residents must be assessed prior to moving to the home. 18.1ci, All staff must receive training in 13.6 adult protection. Section 11 The provider must appoint a CSA Manager, who will apply for registration 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 3 4 5 6 Refer to Standard OP1 OP7 OP8 OP9 OP10 OP15 Good Practice Recommendations The provider needs to update the Statement of Purpose as soon as possible. The social needs of the residents should be addressed in addition to the nursing needs. Residents should have access to other professionals eg. Tissue viability, as necessary. Homely remedies should be agreed with the GP. The provider should arrange the internal training discussed during the visit. Residents should be supported and encouraged to make DS0000066561.V293211.R01.S.doc Version 5.1 Page 19 Ashford Lodge Care Home 7 8 OP16 OP18 their own choices. The complaints procedure needs to be reviewed. The adult protection policy needs to be reviewed. Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Ashford Lodge Care Home DS0000066561.V293211.R01.S.doc Version 5.1 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!