Inspection on 11/11/05 for Ashglade Rest Home

This inspection was carried out on 11th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashglade Rest Home 09/12/08

Ashglade Rest Home 09/01/07

Ashglade Rest Home 20/05/05

Ashglade Rest Home 02/11/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ashglade Rest Home Ashglade Rest Home 178 SouthBorough Road Bickley Bromley Kent BR2 8AL Lead Inspector Announced Inspection 11th November 2005 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 Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashglade Rest Home Address Ashglade Rest Home 178 SouthBorough Road Bickley Bromley Kent BR2 8AL 01322 868684 01322 860351 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) Chislehurst Care Limited Mrs Melanie Stewart Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th May 2005 Brief Description of the Service: Ashglade is an Edwardian detached three-storey house, which has been converted to provide care for 15 older people. It is situated on a busy road in a residential area. On a main bus route between Pettswood and Bromley. There is limited parking to the front of the property. The accommodation for service users is on the lower two floors. A shaft lift provides access between these floors. There is a well-maintained garden to the rear of the property, which can be accessed by a ramp. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by one inspector who was in the home for approximately 5 hours. During that time some service users, members of staff, relatives and visitors to the home were spoken with, some relatives completed written comment cards and their views have also been included in this report. Some policies and procedures were examined and parts of the premises inspected. At the time of this inspection the recently appointed manager has been working in the home for approximately 6 weeks. A minimum of two inspections generally takes place within a 12 months period to all Registered Care Homes. As this inspection may not have covered all the “National Minimum Standard” on this occasion it is recommended that if further information is required a copy of the last inspection report also be obtained. This summary contains a record of the inspection to support the reader to obtain a clearer picture of standards in the home. What the service does well: What has improved since the last inspection? Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 6 Since the last inspection action has been taken to enable service users to have a choice of menu at each mealtime. A Statement of Purpose and Service User Guide have been developed in relation to the care and services provided in the home. A comprehensive pre admission assessment is now undertaken by the manager prior to service user being offered a place in the home. Service users now have the opportunity to participate in the review of their care plans. Medication is now appropriately stored and staff have received training regarding good practice in relation to the administration and recording of medication to service users. At the time of the previous inspection, the smell of urine pervaded some bedrooms; action has been taken to eradicate this problem. At the time of the previous inspection water to baths was found to be too hot to touch, action was taken to reduce the temperature and regular safety checks are now also undertaken. What they could do better: The home needs to ensure that an adequate number of cleaning hours are provided. Staff need to ensure that as far as possible action is taken to prevent unnecessary risk to the health and safety of service users as identified specifically with regards to appropriate storage of cleaning equipment and materials. Action needs to be taken to ensure that service users can access the emergency call system at all times. No action has been taken in response to a requirement made at the time of the previous inspection to consult with the fire officer in relation to an appropriate lock for one bedroom. It is not possible to fit a standard lock, as the room needs to be used to access the external fire escape. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 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. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 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 the following standard(s): 1,4,5,6 Service users are now provided with written information enabling them to make an informed decision to live at Ashglade. Service users are given the opportunity to visit the home prior to admission on a trial basis. EVIDENCE: Since the last inspection action has been taken to produce a Statement of Purpose and a Service User Guide pertaining to the care and services provided in Ashglade. Relatives who spoke with the inspector were advised that copies of these documents would be distributed to relevant parties and should include a copy of the last CSCI inspection report. A more detailed initial assessments had been completed for service users recently admitted, this highlighted the possibility that the service users may have additional needs outside the homes terms of registration. The manager stated in she would discuss her assessment with the GP and seek clarification regarding service users diagnosis and liaise with the CSCI regarding the outcome if a variation to the homes registration is required. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 10 The manager stated that service users are able to visit the home prior to admission to meet staff and other service users and to view the accommodation available. A relative spoken with stated that this opportunity had been given to her mother prior to her being offered a place in the home on a trial basis. Ashglade does not provide intermediate care. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 11 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 Progress has been made in relation to developing care plans within the home. Service users can be confident they will receive the health care they require. Considerable progress has been made to ensure medication is appropriately stored, recorded and administered and so safeguarding the wellbeing of service users. EVIDENCE: The majority of issues raised at the time of the last inspection in relation to the content of care plans have been addressed. The manager stated that service users are now involved in the care planning process and when possible have been asked to sign their care plan. A question of the suitability of the care plan format was discussed at the previous inspection i.e. assessing service users numerous skills, the manager stated that she and staff now use a game of bingo to assess this particular skill. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 12 Staff entries to service users daily records were generally more comprehensive than on the previous occasion, however staff are continuing to write diet taken rather than recording if the service user had enjoyed a particular meal provided, which in the long term could provide information for staff in relation to service users likes and dislikes, menu planning etc. Entries made by night staff projected a clear picture of the service users needs and in addition indicated staff were caring and reassuring to service users at this time, the record also indicated that staff are able to provide service users with refreshments during the course of the night as well as during the day. Documentation seen and service users care plans indicated they receive regular support from the GP and district nurse when required. The chiropodist and hairdresser also attend service users in the home on a regular basis. Since the last inspection action has been taken to address a number of issues raised in relation to medication. Staff responsible for administering medication have received appropriate training and have been assessed as competent to undertake this procedure. On the day of the inspection medication was being appropriately and safely stored. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 13 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): 14,15 The manager is exploring way in which she can maximise the service users personal autonomy and choice. Service users receive a varied choice of meals on the daily menu. EVIDENCE: The manager expressed her views for the future regarding the way she intends to enable service users to express their views, personal autonomy and choice. This has been initiated by holding a service user meeting, minutes of the meeting were seen indicated discussion had taken place with service users, enabling them to express their views regarding a number of day-to-day activities. There was evidence that service users have been able to bring personal possessions and mementos from home, to personalise their own bedrooms. Action has been taken to address the issues raised at the time of the last inspection in relation to menus, whilst the food provided was nutritious service users were not provided with a choice of food at mealtimes. This has now been addressed and service users have a choice of menu at each mealtime. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 14 A visitor to the home stated she had been given the opportunity to have Christmas day lunch with the service users, which she appreciated as alternatively she would spend the day on her own. A record is now kept of any alternative meal provided to service users, to provide written evidence that all service users are receiving a varied nutritious diet. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 15 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 The home has an appropriate complaints procedure in place. Adult protection procedures are in place in order to safeguard service users living in the home. EVIDENCE: Records seen indicated the company has a clear complaints procedure which is accessible to service users and other relevant parties. Relatives spoken with and those who completed comment cards stated they had not felt it necessary to raise any concerns or make complaints regarding the care and service provided. Documentation seen indicated that the home has information regarding the local authority adult protection procedures and staff have access to local authority training in relation to this issue. The manager stated the company has purchased a video training pack in relation to this issue, with staff required to view the video and complete questionnaires regarding the subject matter. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 Service users live in a home free from offensive odours, the home would benefit from an increase in the number of hours provided for cleaning. EVIDENCE: Action has been taken to address the issues raised in the previous inspection regarding the smell of urine in some service users bedrooms, either by replacing or cleaning carpets with an industrial cleaner. Some discussion took place regarding the current number of cleaning hours and shift pattern in relation to cleaning tasks. Although generally all communal areas were clean, dust was apparent in a number of bedrooms i.e. on service users ornaments and mementos, dust was also apparent in some rooms with high ceilings. The manager stated the company was currently reviewing the number of domestic hours required in the home. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 17 Laundry equipment is sited in the basement. The manager stated that new equipment had been recently purchased and this was able to meet the needs of the current service user group. The area also has appropriate hand washing facilities for staff who may have contact with foul material. The basement is also used as a storage area and discussion took place regarding the need for the overall space to be organised with walls and flooring that are readily cleanable. The manager stated this would be addressed. A relative raised the matter of items of laundry becoming lost in the process, the manager stated she taken steps to make the previous system more effective and would continue to look at way of developing the process further. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 18 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): 28,29, 30 Service users will benefit from the increasing number of suitably qualified staff employed. Sound recruitment procedures are in place, which aim to protect service users. EVIDENCE: A number of care staff have competed NVQ 2 in care and other staff member are currently enrolled on NVQ courses. Staff spoken with stated they felt more confident and competent since undertaking training. Staff have also recently attended moving and handling courses and stated this had been valuable in updating their practise and ensuring the safety of service users and staff. Staff stated they had received training day in excess of the minimum of three days recommended in the National Minimum Care Standards Act 2000. Procedures in relation to recruitment were examined, records indicated that staff had competed application forms provided the names of referees, which had been taken up. CRB checks had also been completed in relation to all staff working in the home. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 19 Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 20 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): 31,32,34,35,38 Service users, staff and relatives are confident the home is run in an open and inclusive manor. Some action is required to address safe working practises in the home. EVIDENCE: A new manager has recently been appointed to manage the home on a day today basis; an application for registration has been submitted to the CSCI. The manager was able to demonstrate the way in which she communicates a sense of direction and leadership with service users, staff and relatives, by being accessible and holding regular meetings to ascertain all parties views as well as developing regular supervision to monitor and develop staff working practises and training needs. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 21 Everyone who spoke with the inspector spoke highly of the new manger and thought she was doing a good job. Records seen indicate the home has appropriate insurance cover in place. The manager stated that care staff do not have any contact with service users personal money. All of the service users have relatives or advocates who hold Power Of Attorney status to manage their affairs. When the home pays money for a service i.e. hairdressing on a service users behalf, a detailed invoice is sent to the service users advocate on a monthly basis, this process was confirmed by a relative who spoke with the inspector. Issues in relation to health and safety were discussed. A number of staff have recently updated their first aid qualification and attended moving and handling training. Action has been taken to address the fact water in bathrooms was found to be to hot to the touch at the time of the last inspection. Discussion took place regarding the need to ensure that the H are C symbols on taps of the ground floor bathroom which have fallen off are replaced. Action has been taken to ensure that suitcases are now safely stored. Discussion took place regarding the current emergency call system; there were instances when it was not possible for service users to reach the call system from their bed. The manager stated she was aware of this and the matter would be addressed when the new call system was installed in the near future. During the course of the inspection the industrial carpet cleaner was seen left unattended in the hallway at the bottom of the stairs, this is a main thoroughfare in the home and discussion took place regarding the need to reduce the risk of accidents by ensuing areas are kept free from potential hazards. Cleaning materials were also left unattended for periods of time. Action was taken to remove these hazards before the end of the inspection. As discussed during the previous inspection the fire escape exit from the first floor is via a service user’s bedroom. The manager stated the current service users has stated he does not wish to lock his door, however discussion took place regarding the need to address the issue, as a future occupant may want to lock their bedroom. The fire authority should be contacted to advise on a safe way of securing the door, which enables the service user to have privacy and other occupants of the home easy access to the fire exit in an emergency. The manager stated this would be addressed. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 22 Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 23 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 3 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x 2 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x 3 3 3 x 2 Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 24 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 OP38 Regulation 23(2)(n) Requirement Timescale for action 01/03/06 2 OP38 13(4)(a) 3 OP38 23(4) Ensure that service users can access an emergency call point to enable them to call for staff when assistance when required. Ensure that all parts of the house 11/11/05 which service users have access to be as far is reasonably practical free from hazards to their safety. Consult with the Fire Officer 01/03/06 regarding a means of escape /privacy of service user. 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 Good Practice Recommendations Review number of hours currently provided to undertake domestic tasks in the home. Ensure taps to the bath are clearly marked hot and cold. Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Ashglade Rest Home DS0000061312.V256002.R01.S.doc Version 5.0 Page 26 - 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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