Inspection on 20/01/06 for Ashington Grange

This inspection was carried out on 20th January 2006.

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

Ashington Grange 02/07/08

Ashington Grange 20/06/07

Ashington Grange 09/09/05

Ashington Grange 24/02/05

Ashington Grange 15/07/04

Ashington Grange 28/01/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Ashington Grange Moorhouse Lane Ashington Northumberland NE63 9LJ Lead Inspector Karena M.Reed Unannounced Inspection 20th January 2006 12:30 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 Ashington Grange DS0000040474.V258881.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. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashington Grange Address Moorhouse Lane Ashington Northumberland NE63 9LJ 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) 01670 857 070 01670 854 144 ashingtongrange@highfield-care.com Southern Cross Home Properties Limited Mrs Jane Elliott Care Home 59 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (35) of places Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two specified persons under the age of 65 may be accommodated within the category of DE for as long as they are in residence. The CSCI must be informed at that time so that this condition can be removed. One specified person under the age of 65 may be accommodated within the category of PD as long as they are in residence. The CSCI must be informed at that time so that this condition can be removed. 9th September 2005 2. Date of last inspection Brief Description of the Service: Ashington Grange is a two storey purpose built care home which is situated in a residential area and is approximately one and a half miles from the centre of Ashington. The home provides care for residents who have Dementia and other mental health issues and general nursing care for up to 45 older persons.The home also offers social and personal care for older people. The home is divided into two units called the Charlton Wing and the Milburn Wing.Each unit has its own facilities including single bedrooms, 10 of which are en-suite. Each unit has two lounges and dining rooms and there is safe access to the garden areas. There are bathrooms and toilets near to all bedrooms and communal areas.The home provides wheelchair access to all areas,has assisted baths and wheel in showers and a range of other specialist equipment. Car parking areas are provided at the front and sides of the building giving level access to the home. The home shares the site with another home which is owned by the same company. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not given prior notice of this inspection that took place over 4 and three quarter hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. Records included: 4 care plans, the fire log record, three staff records, the accident book, admission/discharge register, complaints record, staffing rotas, daily communication book and service users personal allowance records .The nurses in charge, administrator, three support workers and cook were spoken to during the inspection. Time was also spent with fifteen service users during the inspection. What the service does well: What has improved since the last inspection? Staffing levels have continued to improve to ensure individualized care is provided as far as possible. Staff training continues. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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 Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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): 1,3,4,5 The home ensures that potential service users are provided with details of the services the home provides which helps them to make an informed decision about coming to stay in the home. Detailed information is made available when a referral is made. The home carries out their own detailed assessment prior to agreeing to admit people into the home to ensure that the home can meet their needs. Staff are equipped with the necessary skills in order to meet the needs of the service users. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 9 EVIDENCE: A Statement of Purpose was available within the home and is available to prospective services to outline the services provided by the home. The service user guide details information in an informal, interesting style to tell people who may be coming to live in the home about services available. The Statement of Purpose and service user guide however require updating, as they do not reflect the merge between the Highfield Group and Southern Cross, which took in the Autumn of 2005. Inspection of records for four service users showed that full assessments had been carried out prior to their admission. A relatively new service user said that they had visited the home and received information verbally and in writing about the way it was run before moving in for a trial stay. The service user was also very happy with the care and attention received. Service users, if they are able, have the opportunity to visit the home as many times as they like to decide if they wish to live there. This could involve tea- time visits, day and overnight stays and can be adjusted to the pace of the service user. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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): 7,8,10,11 There are excellent arrangements in place to ensure that service uses’ health and social care needs are met. Very detailed information is available to ensure that all health care needs are clearly addressed and to ensure that the staff team are fully informed and aware of the support they need to provide. There are sound systems in place to ensure service users are treated with respect and their right to privacy is upheld. Systems are in place to ensure service users that at the time of their death, staff will treat them and their family with respect and sensitivity. EVIDENCE: Inspection of the records for a recent admission showed that an assessment had been carried out prior to their admission. This was combined with information received from the care manager’s assessment of the service user’s care needs. The resulting care plan recorded very detailed information about the health and medical needs of the service user and the amount of staff intervention required in order to provide support. Information on the file was up to date and included: nutritional risk assessment, dependency assessment, Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 11 pressure area risk assessment, malnutrition tool, continence assessment, falls risk assessment , footrests on wheel chair risk assessment, diabetic eating risk assessment, challenging behaviour assessment, assessments for fluids, moving and handling assessments, environmental safety assessment, bedrail risk assessment Daily recordings about the care provided to service users are contained in the service users’ care records. Information is also collected in order that the home can make an assessment of the service users social needs. Service users have a choice of General Practitioner if they are unable to retain their own when they move into the Home. There was evidence that GPs were regularly consulted for advice and treatment. Records were available to show other health personnel visit the home as required and service users are assisted to access chiropody, dental and optical services at least annually or as often as required. All of service users spoken to, said that they were treated well by the staff and well cared for. It was apparent during the inspection that attention was paid to service users’ dignity and staff were seen to act respectfully at all times. Discussion with staff and policies and procedures provided evidence that the death of a service user would be dealt with sensitively. Staff have received training about bereavement and death and dying. Service users are provided with care and support to enable them to live at the home until their death. Facilities are available to enable relatives to stay with their dying relative. Care plans of service users indicate the spiritual preferences and who will be responsible for the funeral arrangements of the service user after their death. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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): 12,14 Service users find the lifestyle experienced in the home matches their expectations and preferences. The Home provides support to service users to meet their health, social and spiritual needs. Social activities provide variation and some interest for service users. Service users have some encouragement to exercise choice and control over their lives. EVIDENCE: Information is collected about the social interests and spiritual preferences of service users, which contributes, to the service users plan of care. Discussion with service users provided evidence that the home and staff do provide whatever level of support is required to ensure that service users have the opportunity to access the local community for health, spiritual and social needs where possible.eg Trips to Newcastle, the local social club and pubs, meals out, trips to the coast. Service users with family enjoy organized entertainment, fund raising fayres, parties and coffee mornings. Activities such as: lotto, bingo, videos, tombolas, dominoes, Pat a dog, sing-a-long, drinks trolley, pamper afternoons also takes place within the home on a regular basis. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 13 A church service also takes place regularly at the home which service users have an opportunity to attend if they wish. Ministers of different religions will visit the home depending upon the spiritual preferences of service users. An activities organizer is employed by the home to ensure that the social needs of service users are met as far as possible. The person consults individually with service users and their key workers to try to ensure that interesting, meaningful activities are available for service users if they wish to take part. Service users are consulted individually about their dietary preferences, rising/retiring and bathing routine. Relatives meetings take place regularly with service users involved where possible. The financial arrangements for eleven service users however did not offer them choice or allow them to retain control of their finances, service users monies were pooled in one account. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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 There is a suitable complaints procedure. Service users and their relatives have confidence that they can raise any issues and know that they will be dealt with. Service users legal rights are protected. EVIDENCE: The home has a complaints procedure but it did not accurately record who owned the home as it referred to the Highfield Group only rather than Highfield and Southern Cross. There has been one complaint about the home since the last inspection that has been investigated by them. Service users names are entered on the electoral register and they are supported to use a postal vote if they wish. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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): 22,23,26 All service users enjoy their own bedrooms some are equipped with the necessary equipment to assist physically dependent service users. There is the necessary specialist equipment for the needs of the service users. EVIDENCE: A tour of the premises was undertaken and a small number of bedrooms viewed. The home is well maintained and there is an ongoing programme of decoration and refurbishment. The front entrance hall however did not create a good initial impression for prospective service users and their families and did not accurately reflect the high standard of care within the home: the welcome mat was dirty and displayed the wrong logo, cushions on some chairs were soiled, the clock on the wall had stopped, some cleaning materials recently delivered were standing in the hallway. The Employers Liability Certificate on display in the hallway had expired in December, however the new valid certificate was displayed before the end of the inspection. The complaints procedure on display was out of date. In the kitchen two large pans contained Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 16 prepared potatoes and cabbage, which apparently were to be used for lunch the next day. Service users care plans indicate the specialist needs of service users and assessments are carried out by the relevant people eg Occupational therapists, physiotherapists, speech therapists to ensure the specialist equipment meets the needs of service users and to assist staff at the home to provide the necessary levels of support. Equipment currently being used by the home includes: adjustable beds, Spenco mattresses, adjustable chairs, wheelchairs, feeding cups, special cutlery, plate guards, 3 hoists, slings, Parker Baths, sensory lights, hip protectors etc. Service users bedrooms were individualized and personalized to their tastes. In one bedroom it was noticeable a pillow was being used with no covering. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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): 28,29 The necessary staffing levels are maintained to meet the needs of service users currently. Service users are protected for the most part by the home’s recruitment policy and practices. The staff have an understanding of the service users support needs. This is evident from the positive relationships that have been formed between staff and service users. EVIDENCE: The home has two units staffed separately with a qualified general nurse and registered mental health nurse on each shift. Examination of staff rotas and discussion with the person in charge and members of the staff team provided evidence that the numbers of staff are as follows: 8.00am-5.30pm 5 carers 1 Nurse 5.30 pm –10.00pm 4carers 1 nurse 10.00pm-8.00am2 carers 1nurse Other staff members are employed for duties such as food preparation and cleaning, administration, activities organization, maintenance and laundry work. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 18 The three staff files looked at did not contain all the information as required by the Care Standards Act 2000. One file contained no photograph of the staff member, another file contained no evidence of a CRB check, another contained no evidence of induction training, nor proof of identity. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to service users. Staff stated that they receive induction training. At least ten members of the twenty member care staff team have now achieved National Vocational Qualifications at level 2 staff confirmed that they also receive advice and /or training in other areas, such as dementia awareness, continence, risk assessment and the necessary statutory training. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,37 The manager is committed to ensuring the home is run for the benefit of service users. There is a very good standard of record keeping which ensures service users needs can be met as individually as possible by the staff team. Service users’ financial interests are not safe guarded by the current system used by the company. The necessary statutory health and safety checks were carried out within the required time scales. Systems are in place to ensure the health and safety of service users and staff as far as possible. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 20 EVIDENCE: The positive comments of service users and staff give confidence that the manager provides good leadership throughout the home and promotes a philosophy of individual care to service users. Discussions with the person in charge manager and the staff records viewed provided evidence that the staff are supported in their roles through regular supervision. Discussion with the administrator and financial records looked at showed service users did not have separate financial accounts until their savings had reached a certain level, otherwise the eleven service users whose monies were kept by the home for safe keeping had their monies in a pooled account. Staff and service users meetings take place regularly. The random sample of records viewed at inspection were comprehensive and accurately recorded apart from the fire log did not accurately record the frequency of fire equipment visual checks, emergency light visual checks, fire alarm sounding and records already identified such as the complaints procedure, Statement of Purpose, service users guide and some staffing records required updating. There is a system in place to ensure that staff are given training in moving and handling skills, fire safety, first aid, infection control and good hygiene. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 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 2 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 x x x x 3 4 x x 2 STAFFING Standard No Score 27 x 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 2 x 2 3 Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 22 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 2 3 4 5 6 7 8 Standard OP21 OP26 OP1 OP16 OP15 OP26 OP29 OP35 Regulation 23(2)(j) Requirement Timescale for action 01/04/06 01/04/06 01/04/06 28/02/06 20/01/06 28/02/06 28/02/06 9 OP37 The home must repair and make operational the shower room. 13(1)(3), The home must provide suitable waste bins with lids in all bathrooms and lavatories. Reg 4(1)c The Statement of Purpose and Schedule service user guide must be 1 updated. 22(7)(b) The complaints procedure must be updated. 16(2)(i) Vegetables must not be prepared and left standing for long periods of time. 23(2)(d) The cushions and door mat at front entrance must be cleaned. 7,9,19 Staff files must contain all the Schedule relevant information as required 2 by the Care Standards Act 2000. 20(1)(2)( Separate bank or saving a)(b) accounts are retained for each service user where money is held by the home. 23(4)(c)(v Fire log to accurately record the ) frequency of fire checks. 01/04/06 21/01/06 Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 23 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 Refer to Standard OP4 Good Practice Recommendations To ensure carers receive more training about needs of people with memory loss. Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Ashington Grange DS0000040474.V258881.R01.S.doc Version 5.0 Page 25 - 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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