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Inspection on 23/02/07 for Ashgrove Residential Home

Also see our care home review for Ashgrove Residential Home for more information

This inspection was carried out on 23rd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents who were spoken with during the inspection expressed their complete satisfaction with their quality of life at the home, describing how staff respect individuality, choice and maintain dignity. The care team support residents to maintain their independence but provide discreet assistance when necessary. The home has good links with healthcare professionals in the area and seeks appropriate professional advice when required. During a group discussion with residents, one individual described Ashgrove as a `home from home` - a view that was shared by the other residents present.

What has improved since the last inspection?

There were no requirements made following the last inspection. This is a home that operates well and remains committed to providing a good standard of care

What the care home could do better:

There were no requirements made at this inspection.

CARE HOMES FOR OLDER PEOPLE Ashgrove Residential Home The Old Vicarage Church Lane St Martins Oswestry Shropshire SY11 3AP Lead Inspector Rosalind Dennis Key Unannounced Inspection 23rd February 2007 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 Ashgrove Residential Home DS0000020655.V296603.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. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashgrove Residential Home Address The Old Vicarage Church Lane St Martins Oswestry Shropshire SY11 3AP 01691 774101 NONE 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) Mr Brian William Case Mrs Helen Case Mr Brian William Case Mrs Helen Case Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: Ashgrove is a small privately owned residential home providing personal care for ten older people. The registered proprietors are Mr and Mrs B W Case who have been at the home since 1987 and live in the converted coach house on the same site. Ashgrove is partly an old vicarage and partly purpose built extension, located in the small village of St Martins, Nr Oswestry, accommodation is all on ground floor level for service users, and is within easy reach of local resources. It is set out in its own grounds with pleasant gardens and a terrace for residents to use. There is a large garden where home grown produce is cultivated. Visitors to the home are frequent. The home has good links with the local community. The proprietor confirmed that, at the time of this inspection, the fees charged by the home are £355 per week. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted by one inspector over a period of around 5 hours. Time was spent speaking with residents, observing staff working, looking at documentation, and areas within the home that are accessible to residents were observed. On arrival at Ashgrove the deputy manager was in charge, the home was functioning well and all residents appeared well cared for, cheerful and eager to contribute to the inspection. The proprietor arrived during the morning to provide assistance to the inspection process. The management and staff are clearly committed to ensuring residents at Ashgrove receive good quality care. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements made at this inspection. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 6 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. Ashgrove Residential Home DS0000020655.V296603.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 Ashgrove Residential Home DS0000020655.V296603.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): 1 and 3 Quality in this outcome area is good. The home has a satisfactory admissions procedure that provides for an effective needs assessment for each resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr or Mrs Case visit prospective residents prior to admission to the home, the assessments which are conducted ensure that the home is able to plan care to meet the individual’s needs. Observation of three residents’ care files confirmed that assessments are consistently undertaken. One resident who had been admitted to Ashgrove recently spoke of her satisfaction with the admission process and described how all members of staff at the home had made her feel very welcome. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 9 The home has a statement of purpose and service users guide, which both contain the required information about the home and services offered. Ashgrove Residential Home DS0000020655.V296603.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 and 10. Quality in this outcome area is good. The staff are sensitive to the personal and spiritual needs of each resident and good multi-disciplinary working ensures healthcare needs are fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are very positive about the care they receive and the caring attitude of all members of the staff group. Residents were observed being treated with respect by staff who responded to residents’ requests discreetly and sensitively. The home’s care documentation provides information regarding the care required to meet each residents needs, and when changes occur these are documented clearly within daily records and on the care plan. A GP visits from the local practice on a regular basis and the District Nursing team provides nursing support when needed. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 11 Medication administration is restricted to staff who have undertaken training in the ‘safe handling of medicines’ and on the day of this inspection the securing, administration and recording of medication appeared satisfactory. Ashgrove Residential Home DS0000020655.V296603.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): 12, 13, 14 and 15. Quality in this outcome area is good. Routines at Ashgrove are planned around individual needs and wishes and residents are supported to make choices in all aspects of their daily living. The home provides a varied and well balanced diet, which takes into account individual likes and dislikes along with seasonal changes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a lunchtime discussion a group of residents spoke of how staff respect individual likes and dislikes and promote choice with daily living activities such as meals, activities and preferred times to get up/ go to bed. A music and movement session took place during the inspection, which the majority of residents attended. Other activities are organised on a daily basis by staff according to residents’ wishes, this includes jigsaws, bingo, reading and representatives from the local church visit regularly. All residents spoken with confirmed their satisfaction with the level of activities and how staff respect their decision if they do not want to participate. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 13 Residents were complimentary about the standard of food provided, commenting on how the summer/autumn months are particularly enjoyable when vegetables grown within the grounds of Ashgrove, are used in the home’s meals. A record is made of meals served and this confirms choices are provided. Snacks and drinks are offered between meals and staff and residents confirmed that special events, such as birthdays are celebrated. Ashgrove Residential Home DS0000020655.V296603.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 and 18 Quality in this outcome area is good. The interests of residents are protected through the home’s complaints procedure and staff are fully aware of their role in protecting residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints procedure and residents spoke of how they would feel comfortable in raising concerns with either Mr or Mrs Case or the deputy manager. Mr Case confirmed that the home has not received any recent complaints and CSCI have also not received any complaints in respect of this home. Staff confirmed their awareness of the local adult protection procedure, a copy of which was observed to be readily available within the home. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The standard of the environment is good providing residents with a comfortable and clean place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All parts of the home that were observed were clean and decorated to a good standard. The home has sufficient communal rooms, such as lounges to provide ‘quiet areas’ for residents and visitors to access if they wish, these rooms were observed to be well equipped, warm and welcoming. Bedrooms are personalised with photographs and possessions-one resident commented on the homely atmosphere describing Ashgrove as a ‘home from home’. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 16 Ashgrove Residential Home DS0000020655.V296603.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): 27, 28, 29 and 30 Quality in this outcome area is adequate. Residents are supported by staff who have the necessary skills and abilities to meet the needs of the current residents. The home has a robust recruitment procedure, which protects residents from the employment of inappropriate staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels at the home appear sufficient to meet the needs of the current residents-staff were observed to respond promptly to residents requests for assistance and residents confirmed that day or night, staff were always available. Residents commented positively that the staff group encourage independence depending on individual abilities. Observation of two staff files demonstrates that the home ensure all information required by regulation is obtained prior to commencement of employment. An induction programme is provided which incorporates observation of practice and assessment of competence and staff are supported to undertake NVQ awards in care. It was confirmed that four staff have attained NVQ Level 2 and 2 staff have attained Level 3. Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 18 Staff have received training in safe working practice topics and although Mr Case confirmed that other training opportunities have not been as great as in previous years, observation and discussion with staff confirmed they have the required skills and abilities to meet the needs of the current group of residents. Ashgrove Residential Home DS0000020655.V296603.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 and 38. Quality in this outcome area is good. The management approach at Ashgrove creates an open and positive atmosphere from which residents benefit. The home is well maintained and the staff group appropriately skilled to ensure that the health, safety and welfare of residents is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observations made during this inspection show that the proprietors and staff are committed to ensuring residents receive a good standard of holistic care, which is based on individual likes/dislikes and choice. Throughout the inspection residents were keen to share their views on how the home meets Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 20 their needs and it was apparent that a good rapport exists between management, staff and residents. The proprietors are fully involved in the day-to-day running of the home and the deputy manager provides continuity to the home when the proprietors are not on duty. Comments from residents provide evidence that the proprietors are continually monitoring quality through their presence in the home. Mr and Mrs Case are due to attend training in quality management, which should enhance the formal development of this area. A full audit of maintenance/service records was not undertaken at this inspection, observations during the inspection confirmed a safe environment and equipment appeared well maintained. Ashgrove Residential Home DS0000020655.V296603.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 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 3 3 X 3 X X 3 Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Ashgrove Residential Home DS0000020655.V296603.R01.S.doc Version 5.2 Page 24 - 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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