Inspection on 08/03/06 for Ashgrove Residential Home

This inspection was carried out on 8th March 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

Ashgrove Residential Home 23/02/07

Ashgrove Residential Home 20/06/05

Ashgrove Residential Home 24/02/05

Ashgrove Residential Home 05/07/04

Ashgrove Residential Home 03/02/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Ashgrove Residential Home The Old Vicarage Church Lane St Martins Oswestry Shropshire SY11 3AP Lead Inspector Lorraine Briggs Announced Inspection 8th March 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 Ashgrove Residential Home DS0000020655.V268219.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. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 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 Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 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. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection reviewed key standards only as the home is currently considered to be performing well and thus warrants the application of a reduced methodology. The inspection was announced and commenced at 09.30am. It included observing activity within the home, inspecting the premises, looking at records and case tracking and talking to the proprietors, staff and a number of residents. Prior to the inspection comment cards were distributed to service users, their families and visiting professionals, 4 were returned from service users, 3 from relatives / visitors, 1 from a General Practitioner, 1 from a Care Manager and 1 from a District Nurse. The Proprietors and staff on duty were welcoming and helpful throughout the inspection. It was found that the National Minimum Standards assessed had been met, with a number exceeded, and that the overall quality of care provided was good. All residents appeared happy, content and very well cared for and those who were able expressed complete satisfaction with their quality of life at the home. Comments recorded from Service Users included: ‘My care here is second to none, if all homes were this good there would be no need for inspections.’ Visitors, relatives and all visiting professionals have also expressed satisfaction with the service and care the residents are receiving and have been complimentary regarding the management and care practices at the home. Comments received from questionnaires included: ‘Extremely high standards of medical, social and spiritual care. Nutritional care very good.’ ‘My aunt has been at the home for the past two years. She says that she could not be looked after better anywhere. The meals are very good, they will even cook special food if they know she dislikes something on the menu.’ ‘I am very pleased with the care and attention that my mother receives at Ashgrove. This time last year my mother was very ill and without the care and support for my mother and myself I do not believe that my mother would still be alive. A wonderful place and wonderful staff. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 6 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. As already stated the management and staff continue to work hard in meeting the requirements expected of them to deliver a personal service to all living at the home. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 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. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 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 Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 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): 3 All new service users are assessed before moving into the home to ensure their needs can be appropriately met. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide, which includes all the required information for prospective residents. Either Mr or Mrs Case assess an individual prior to their admission to the home. It was evident from discussion with residents that this had taken place prior to their admission. This information along with an assessment supplied by a placing Social Worker (if relevant) then inform a decision. All aspects of the admission are discussed and considered including the impact on the current resident group. Documentation examined indicated that individuals have a comprehensive assessment of their needs prior to admission, which is reviewed and amended as requirements change. Ashgrove Residential Home DS0000020655.V268219.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 and 10 There is a clear care planning process in place. The staff are sensitive to the health, personal and spiritual needs of each service user and meet these in a professional manner. There is evidence of regular review and of good multi disciplinary working taking place on a regular basis. Medication is dealt with in accordance with the homes policies and procedures. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 11 EVIDENCE: It was evident during the inspection from looking at records, inspecting the facilities and chatting to staff, visitors and residents that individual health, personal and social care needs were being met. The home has established close working liaisons with other health care professionals such as District Nurses, Community Mental Health Nurses and General Practitioners. Each resident has a personal medical history sheet, on which significant medical events are recorded, along with outcomes. Securing, administration and the recording of medication appeared to be generally satisfactory and some staff have undertaken accredited training with Walford College. Residents were being treated with respect and staff were working both professionally and sensitively in meeting individual needs. Those residents and visitors spoken to were complimentary regarding the quality of their lives at the home and visiting health professionals praise the management and care standards there. A comment received from a visiting General Practitioner states: ‘Extremely high standards of medical, social and spiritual care. Nutritional care very good.’ Ashgrove Residential Home DS0000020655.V268219.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 and 15 Individuals are encouraged to exercise choice in relation to daily living. Service users are offered a varied well balanced diet, which takes into account individual’s likes and dislikes along with seasonal changes. EVIDENCE: Service users were happy to share with the inspector their experiences of daily living at the home. This indicated that individual choices are promoted and encouraged with service users. Ashgrove is very much part of the community of St Martins. Mrs and Mrs Case submit an article for each addition of ‘Chatabout’ – the village journal. The magazine is available for residents to read at the home. Residents and staff have recently held a coffee morning which raised £425 for the ‘Jeans for Geans’ charity. Special events are held to celebrate events such as valentines day, the wedding of Charles and Camilla and Christmas. Photograph seen during the inspection indicated that the events are very much enjoyed by residents and staff, with a great deal of effort taken over decorations and the creation of special cakes. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 13 All service users were very complimentary about the standard and choice of food provided. It was apparent that the menu is changed to incorporate seasonal changes. Many of the vegetables used for the meals are ‘home grown’ within the grounds of Ashgrove. A menu is recorded to support the variety and choice of meals. ‘My aunt has been at the home for the past two years. She says that she could not be looked after better anywhere. The meals are very good, they will even cook special food if they know she dislikes something on the menu.’ Ashgrove Residential Home DS0000020655.V268219.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): 16, 17 and 18 There is a clear complaints procedure in place. EVIDENCE: It was confirmed by the Mr and Mrs Case that there have been no complaints since the last inspection. Both Mr and Mrs Case work within the home on a daily basis. They are therefore on hand to deal with minor concerns, received from residents, and deal with these in a professional manner without delay to prevent them becoming a formal complaint. Service users were complimentary about the staff group listening and dealing with any issues that they raise with them in a satisfactory manner. The home has all necessary documentation in relation to the protection of vulnerable adults and this subject has been included in staff training. Ashgrove Residential Home DS0000020655.V268219.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, 20, 24 and 26 The home is well maintained and comfortable both indoors and outdoors and offers accessible grounds and seating for service users. Individual accommodation is furnished and equipped to a high standard. EVIDENCE: The location and layout of the home are suitable for elderly residents. Communal rooms are well equipped and are warm, homely and welcoming. Bedrooms are personalised and suit individual needs and the gardens and grounds are attractive and well maintained. The dining room has been redecorated since the last inspection visit. At the time of the most recent Fire Officer Officer’s inspection matters were reported to be satisfactory. It was evident that the proprietors and staff work hard to maintain this environment. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 16 At the time of this inspection the standard of hygiene and cleanliness was excellent. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Residents appear to be supported by a well trained and committed staff group who are meeting the needs of each individual in a sensitive and professional manner. EVIDENCE: Recruitment at the home is thorough and all elements required by Schedule 2 of the Care Home Regulations are maintained on file. Staff turnover at the home is very low, meaning that residents benefit from having a stable staff team. Two staff have been recruited since the last inspection, the files of these staff were inspected. The proprietors continue to support staff to undertake their NVQ awards, four staff have now achieved this qualification. A good variety of other training has been undertaken and staff on duty indicated that they were very sensitive to the service users needs and disabilities and that their attitudes and practice are monitored by the proprietors. Staff spoken to were complimentary regarding their working environment and the quality of life for the residents at the home. Ashgrove Residential Home DS0000020655.V268219.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 and 38 There are clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the residents benefit. EVIDENCE: The proprietors, Mrs and Mrs Case have run the home for a number of years. They involve themselves fully in the day-to-day running of the home, work alongside the staff with a clear sense of purpose and can relate to matters pertaining to the National Minimum Standards. The manner in which the Proprietors and staff responded to this inspection indicated that a sound management approach is in place and that staff are committed to achieving best practice and to developing equal opportunities. Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 19 Quality assurance systems are in place and there was evidence available to indicate the proprietor ensures, so far as is reasonably practical, the health, safety and welfare of service users and staff. At the time of this inspection no potential hazards were identified. All relevant records required are maintained in a professional manner. Ashgrove Residential Home DS0000020655.V268219.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 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 3 18 3 3 3 X X X 3 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 3 Ashgrove Residential Home DS0000020655.V268219.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? 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.V268219.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. 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