Inspection on 09/09/05 for Ashington Grange

This inspection was carried out on 9th September 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 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

Ashington Grange 02/07/08

Ashington Grange 20/06/07

Ashington Grange 20/01/06

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 Irene Bowater Unannounced 9 September 10:15 am th 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 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 B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashington Grange Address Moorhouse Lane Ashington Northumberland NE63 9LJ 01670 857 070 01670 854 144 ashingtongrange@highfield-care.com Highfield Home Properties Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jane Elliott CRH 59 Category(ies) of DE(E) Dementia - Over 65 - 24 registration, with number OP Old Age - 35 of places Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Two specified persons under the age of 65 may be accomodated within the category DE for as long as they are in residence.The CSCI must be informed at that time so that this condition can be removed. 2 One specified person under the age of 65 may be accomodated 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. 24th February 2005 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. Date of last inspection Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over five hours. The registered manager was available and assisted throughout the inspection. Eleven staff, eight residents and one visitor were spoken to throughout the day. Two inspectors carried out the inspection. Both initially toured the home, then one spent time in the office examining records and the other inspector spent time with residents and staff. What the service does well: What has improved since the last inspection? The home has experienced staffing problems. Since the last inspection a recruitment drive has been successful and staffing problems have decreased. Staff now have supervision with senior staff to ensure they remain competent and are enabled to develop their skills. Staff now adhere to procedures for the safe administration of medicines. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 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 B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 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 standard(s) 3,5 The admission procedures are comprehensive and ensure the staff can meet residents assessed needs. EVIDENCE: Five care plans were examined and each has comprehensive preadmission assessments, which were undertaken by the manager or senior staff in the home in line with the policies and procedures and supported by the company documentation. The resident’s also have a care management assessment, which is provided to the home on admission and from these documents an individual care plan is produced. All residents are encouraged to visit the home before admission. The residents move in on a trial basis and then have a review before deciding to move in on a permanent basis. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,9,10 There is a consistent and clear care planning process in place, which provides the staff with the information they need to meet resident’s needs. The health needs of residents are well met with evidence of good multi disciplinary working taking place. Staff have a good understanding of the residents support needs, which promotes residents right to privacy, dignity and independence. EVIDENCE: Each resident has an individual plan of care, which is based on the admission assessment. The five care plans examined were found to be comprehensive and show a process of assessment, planning, and evaluation and re assessment. The care plans follow a recognised nursing model of care, which covers all aspects of daily living. The plans showed that validated assessment tools and risk assessments are available for the prevention of falls, nutrition, wound care, moving and assisting, continence promotion and mental health status. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 10 The recording of the nursing action taken for wound care was satisfactory with evaluations being dated and signed. The care plans are reviewed at least monthly and the Manager undertakes a monthly random audit. The plans showed that they are regularly reviewed and up dated and that reviews are regularly held with residents and their representatives. The care plans showed that the residents have access to all NHS services and facilities. There is a good range of specialist mattresses for the promotion and prevention of pressure sores. Specialist advice is sought and acted on for continence care, nutrition and mental health care. The home has a nurse practitioner who works with other professionals and supports the home staff to ensure a high level of clinical care is provided. The home has policies and procedures for the safe storage, receipt, handling, administration and disposal of medication. The records examined were in line with guidance and legislation. The problem regarding signature gaps on the Medicine Administration Record has been resolved. The staff spoken to were aware of the need to maintain residents privacy as part of their care delivery. Personal care is carried out in private and staff were seen to knock on bedroom and toilet doors before entering, two residents specifically said staff would knock on their door before entering their room. The residents spoken to were complimentary about the care they received and said staff treat them in a kind and caring way. Examples of the comments made were that the staff “are lovely” and “staff always try hard”. The staff were observed to address the residents by their preferred name and there was a good relationship between the residents and the staff . Residents can choose to have a telephone in their own room although they pay for this. There is a payphone where residents can make calls in private. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 11 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 standard(s) 13,15 The staff enable the residents to maintain and develop social and family contacts. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets their taste, choices and specialist needs. EVIDENCE: The residents are encouraged to maintain links and contact with family and friends. One relative spoken with visits the home on a daily basis. It was confirmed that visitors’ are welcome at any time and they are encouraged to join in daily life at the home. The residents are offered three meals a day and residents on the day were seen eating heartily. One resident said that the “food is really nice”. There is a choice of all meals or choices from the alternative menu. The meal being served was of ample portion size, hot and well presented including “home made chunky type chips. Those residents unable to feed themselves were offered assistance in a sensitive discreet manner. A variety of cold drinks and biscuits were available throughout the day. The residents confirmed that fresh fruit is offered, usually on the afternoon tea trolley as an alternative to the biscuits. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 12 There was an ample supply of fresh, frozen, tinned, dried and fresh food available all of which was appropriately stored. The kitchen staff were aware of residents specialist needs including how to fortify foods for those who have poor appetites or those who have lost weight. The kitchen was generally clean and well organised. The records were up to date for freezer, fridge and core food temperatures and all food was stored appropriately. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Staff have knowledge and understanding of protection issues, which protects residents from possible risk of harm or abuse. EVIDENCE: There are comprehensive policies and procedures for residents and their representatives to follow should they have any concerns or complaints. The records of all complaints were detailed and the outcomes clearly recorded. Information on how to make a complaint is clearly displayed throughout the home. The provider is investigating currently one complaint. There are policies and procedures in the home for staff to follow should there be any allegation or suspicion of abuse. The home follows the Local Authority Procedural Framework for the Protection of Vulnerable Adults and currently 25 staff have completed appropriate training. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24,26 The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: The location and layout of the home is suitable for the residents who live there. It is split into two units called the Charlton Wing and the Milburn Wing. Each unit is self contained, well maintained with access to safe, nicely kept garden areas. Two residents confirmed that they enjoy spending time in this area in the warmer weather. All areas are wheelchair accessible and a passenger lift services the upper floor. Each unit has two lounges and two dining rooms. All communal areas are nicely decorated, and fitted with domestic style furniture which meets residents needs. The corridor carpet on the EMI nursing unit was showing signs of wear. There are toilets and bathrooms close to all resident areas and each unit has Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 15 10 bedrooms with en suite facilities. The shower room opposite room 41 has been out of use for some time and there is a slight stale odour in this room. All of the residents have been encouraged to bring personal items into the home, which makes the bedrooms individualised and reflects their previous lifestyles. The home provides adjustable beds for residents who need nursing care. All of the bedrooms are for single occupancy. The laundry was well organised and has suitable storage for both soiled and clean linen. The staff are aware of infection control procedures and were observed to follow them on the day of inspection. The sluices were tidy, clean and odour free and the disinfectors were working. The home was clean, tidy and free from offensive odours. Currently the home does not provide liquid soap and paper towels in all bedrooms to enable staff to effectively wash their hands. There are several toilets and bathrooms, which do not have suitable, waste bins, which are foot operated. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 There has been some progress made in addressing staffing shortages, which has resulted in residents’ receiving a consistent standard of care within the home. EVIDENCE: The home staffs each unit separately. During twenty-four hours there are two qualified nurses on duty, one General Nurse and one Registered Mental Nurse. In the morning each unit has five care staff and in the evening there are four care staff. There are two care staff on duty overnight with the qualified nurse. The home also employs an administrator, chef, kitchen assistants, housekeeper, maintenance person, activities organiser and domestic and laundry staff. The home benefits from a nurse practitioner that works five mornings a week. The home has comprehensive policies for the selection and recruitment of all staff. Five staff files were examined and found to contain two references, proof of identity, Criminal Record Bureau checks, medical checks and terms and conditions of contract. The registered manager completes a monthly training analysis to ensure the staff are competent to care for the residents needs. Training covers all safe working practices, wound care, dealing with challenging behaviours, Protection Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 17 of Vulnerable Adults and nutrition. The home receives a six monthly training support visit from the company. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36,38 The manager demonstrates clear leadership and direction with staff demonstrating awareness of their roles and responsibilities. The health and safety if residents, staff and visitors are promoted as far as reasonably possible. EVIDENCE: The registered manager is a first level nurse who has many years experience working with older people. She continues to up date her training as set out by the Nursing and Midwifery Council and is endeavouring to complete the Registered Managers Award by the end of 2005. The records show that formal supervision is now undertaken which covers areas of daily practice and career needs of individual staff. All staff undertake a comprehensive induction programme and all staff are supervised by qualified nursing staff on a daily basis. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 19 The home maintains up to date records for all external contract maintenance. All maintenance checks for fire, water temperatures were recorded and up to date. The staff receive training in all safe-working practices including first aid, moving and assisting, food hygiene and infection control. The fire training and records were clear and up to date. A fire risk assessment has been completed for the current year. On arrival it was observed that the fire exit in the front of the building was being temporarily used to store incontinence pads, which had just been delivered. These were moved to an appropriate storage area and the Manager was reminded of the importance of maintaining clear fire exits at all times. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 2 2 x x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x 3 x 3 Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 21 NO 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. 1. 2. Standard OP 21 OP 26 Regulation 23 13,16 Requirement The home must repair and make operational the shower room. The home must provide suitable waste bins with lids in all bathrooms and toilets. Timescale for action 1/2/06 1/2/06 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 OP 26 OP 31 Good Practice Recommendations It is highly recommended that liquid soap and paper towels be provided in all resident rooms to enable effective staff handwashing. The manager should continue to progress with the Registered Managers Award. Ashington Grange B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 B53 B03 S40474 Ashington Grange V234474 090905 Stage 4.doc Version 1.30 Page 23 - 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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