Inspection on 08/01/07 for Ashlands

This inspection was carried out on 8th January 2007.

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

Ashlands 17/11/08

Ashlands 02/12/05

Ashlands 03/10/05

Ashlands 31/08/05

Ashlands 01/03/05

Ashlands 09/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ashlands 152 Southwell Road East Rainworth Mansfield Nottinghamshire NG21 0EH Lead Inspector Roger Harrison Key Unannounced Inspection 8th January 2007 09:15 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 Ashlands DS0000060714.V315938.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. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashlands Address 152 Southwell Road East Rainworth Mansfield Nottinghamshire NG21 0EH 01623 792711 01623 792711 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) Mrs Manonmany Wragg Audrey Bools Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within category OP Date of last inspection 2nd December 2005 Brief Description of the Service: Ashlands is a two storey detached building converted and adapted to provide care for older people. The home has good access to local facilities. There is ample parking at the front of the home and there is a large pleasant garden area at the rear of the building, which is secure and well maintained for residents use. Ashlands is Registered for 21 beds, with bathrooms being located on both floors and some rooms having private en-suite facilities. On the ground floor of the home there is a dining area and two lounges, which are used regularly by residents. The home has been adapted to meet the needs of service users with a physical disability. Adaptations and equipment include bath hoists, mobile hoists, handrails, grab rails and a passenger lift. Charges made by the home for residential care on 08/01/07 range from: £326.00 – £376.00 pw. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by the inspector reviewing all the Inspection records and information provided by the Manager about Ashlands, and through undertaking a visit to the home using a method of inspection called “case tracking”. This involved identifying three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at Ashlands. The inspection visit was also used by the inspector to talk to the manager and home owner, look at information on care plans and files, and to talk to residents, family members and care staff while observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 6 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 Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 7 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): 3 [Standard 6 N/A] Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are assessed prior to admission and they have access to information about the home, which helps them decide whether the home will meet their needs. EVIDENCE: Before carrying out the inspection visit the manager provided a copy of the homes service user guide and statement of purpose. The manager said that these two documents are provided for anyone who is thinking about moving into the home to help them to understand what is available and the level of support they can expect to receive. The manager said that new residents are encouraged to visit the home before they move in. The manager also provided information about how pre admission assessments are arranged and carried out during the inspection visit to show that new residents have their needs assessed before any move takes place. The manager said that this helps the care team to decide whether needs can be met safely. New residents are Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 8 offered a trial period, which is used to carry out a further assessment and review of need. A resident said “I was satisfied with the information received about the home and still feel this is the right place for me”. One family carer said, “We visited twice without an appointment and knew that this was the right place for mum to be”. Ashlands does not provide an intermediate care service. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health, personal and social care needs are set out in an individual care plan. Resident’s health needs are being met. The manager has policies and procedures in place, which staff follow in order to support residents with their medication needs. Residents are treated with respect and supported to maintain their dignity. EVIDENCE: The manager provided care plan records during the inspection visit, which showed how assessed needs are being met. Any risks, which had been identified, were recorded on a risk assessment, which is reviewed as part of the overall plan to make sure any changes in need are met. Since the last inspection the manager has taken action to ensure reviews are completed each month with detailed records kept on each plan. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 10 Residents and family carers said that they are treated with dignity and respect by the whole staff team and provided comments ranging from “Could not be better” and “the people who look after us do a good job” to “The care and attention mum receives is excellent, they also care about us as a family and that is important too”. The manager confirmed that the home has a policy and procedure for helping residents with their medication needs and that residents are supported to self medicate whenever possible. On the day of the inspection visit all residents needed some level of support with their medicines. Medicines are stored in a locked room and cabinet and put in a locked mobile trolley when being used. The manager said that only those senior staff members who had received training were responsible for supporting and giving medication to residents. A record of training achieved was available on staff files. Medication records are kept with the medicines and are used to show when medicines have been given. These records were fully up to date and a senior staff team member was observed providing support by working with each resident to ensure their medication was taken in the way prescribed, and at a time to suit each residents need. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to take part in a range of activities, maintain control over their lives and receive a balanced and varied diet, which is provided in the way residents wish. EVIDENCE: The manager provided information contained in the care plans to show that individual residents religious and cultural needs are being supported. Religious services are held within the home to match the needs of the current group of residents. Those who wish to take part in community activities are supported to do this and residents said that their family members are always made to feel welcome and are regarded by the manager as an important part of the support network in place for residents who wish to have family contact. During the inspection visit family carers and visitors were observed coming and going. One family carer commented about activities provided at the home, saying, “We as a family will attend any functions and evening events – they are really good”. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 12 The home does not currently employ an activity worker so the manager and care team arrange activities through discussions, reviews and residents meetings. Monthly reviews held on care plans are detailed and help to show that residents are asked about their interests. Residents said that entertainers visit the home and that they are encouraged to take part in activities but most residents said that they like to arrange their own activities. One resident said, “I don’t always wish to participate due to watching my TV programmes and listening to radio and music tapes”. The manager confirmed that menu plans are used to make sure residents are provided with choice and variety each week. Menus include a vegetarian option and ethnic dishes are available. Menu cards are provided in the homes dining area, which are easy to see for those who residents who do not see well. Residents said that they felt the meals at the home are very good with comments ranging from “The food couldn’t be better” to “I think the food is great”. One family carer said “The food is always well presented, the menu is varied and well thought out” and another carer commented, “My mother enjoys her food here”. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they are evident. The Care team know how to act in order to protect residents from abuse. EVIDENCE: Before carrying out the inspection visit the manager confirmed that she has a policy and procedure for dealing with any complaints formally and said that she makes every effort to resolve any concerns that residents raise informally wherever possible. Records available showed that there had been no formal complaints made during the last year. The manager showed that there is a complaints log in reception and there is also a procedure notice, which is used to openly encourage residents or visitors to raise concerns as soon as they occur so they can be addressed together. Residents said that they felt safe living at the home and that they were confident about raising any complaints they might have with the staff team and manager. One family carer who was visiting the home said, “I like coming in I feel welcome and part of the place. If I have any concerns I know who I should speak to”. The manager and residents said that residents meetings are held to enable residents to raise concerns. One resident commented, “If I am not happy Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 14 about anything I pass my concerns to my wife who will inform the carers” and another said “I know there are staff members available if I need to talk to them”. A family carer said, “I have had no reason to complain, my mother has been here for three years”. The manager and staff team said that training had been provided so that they knew how to act in order to protect residents from abuse. The manager showed that she is obtaining updates on local authority procedures and is arranging further training to build on the team’s current skills. During the inspection visit two staff members described clearly the action they would take to keep residents safe from harm. Ashlands DS0000060714.V315938.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 adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and safe but the bathrooms and the laundry room need refurbishing. An internal environmental audit of the care home is needed to develop a clear action plan with timescales, which fully identifies and addresses all the environmental needs of the home. EVIDENCE: During the inspection visit the inspector toured the building. The home was well furnished and resident’s said they were supported to personalise their rooms in the way they wished. Communal areas in the home include a large and small lounge and a dining room. The lounge areas have large windows, which provide residents with views of the large well-maintained gardens. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 16 Since the last inspection the manager has taken action to arrange some decoration work in the laundry and bathroom areas of the home, and since the last inspection radiator covers have been fitted on most radiators, which residents said helps them to feel safe. However, parts of the home are in need of updating as some of the carpets are worn and the bathrooms and laundry areas on the ground floor would benefit from being fully refurbished. The manager said she fully recognises that the home is in need of an overall internal update and that bathrooms, the laundry room and carpets need to be given priority. After a discussion together with the manager and home owner together at the end of the inspection visit it was confirmed that plans are already being made to update the bathroom, carpets and laundry room and that action will be taken to commence and complete an audit of the environment, which will be used to identify the specific and general areas that need updating with timescales for the work to be completed. Ashlands DS0000060714.V315938.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 good. This judgement has been made using available evidence including a visit to this service. There are currently sufficient numbers of safely recruited care staff available at the home with appropriate training and skills to meet the needs of residents. EVIDENCE: The manager provided staff files, which showed that references and checks are carried out to make sure recruitment is carried out safely. An induction checklist is being used by the manager to support new staff and one new staff member said that she had received a good induction and support from the manager to enable her to carry out her duties safely. Training records were available on staff files to show that staff had attended a range of training courses. The manager said she is also developing a full training plan for the New Year to show the courses, which have been provided already for staff to enable any gaps to be easily identified and acted on. The manager provided records showing that more than half of the current staff team have completed or are undertaking NVQ training. Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 18 Staff team members described the training they had received and confirmed that staff had been provided with moving and handling training. Staff team members also confirmed that they seek support from senior team members and a deputy manager when needed. Residents said that they felt the staff did a good job and one resident said, “They are always so busy but do take time to tend to my needs and know how I like things in general”. Ashlands DS0000060714.V315938.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. This judgement has been made using available evidence including a visit to this service. There is a registered Manager in post who regards residents health, safety and welfare as central to the service provided. Residents financial interests are safeguarded. EVIDENCE: Since the last inspection the manager has applied for, and been successful in becoming registered to manage the home. The manager confirmed she has developed a full range of policies and procedures, which the staff team on shift during the inspection said they were aware of and that they use to meet the health and safety needs of residents. The records in place on staff files provided information to show that all staff have had access to training and management support to enable them to meet residents needs in the way Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 20 procedures say they should be. Residents said that they trusted the manager and one resident said, “I’m very happy with the care that is given here”. Another resident said, “I fully trust the manager and know if there are any problems she helps sort them out”. The manager confirmed that she encourages residents and family members to manage their personal monies wherever possible but that she does manage resident’s personal allowances where this is requested and provided records, which were randomly checked and found to be accurate during the inspection visit. During the inspection the home owner visited the home and confirmed that she has commenced planning for the future upgrade of the home environment with the manager. The manager provided a questionnaire, which is going to be given to residents and their family carers so that they can provide feedback on any developments they would like to see at the home. The manager also confirmed she is planning to produce a residents magazine as part of the future development of information sharing. The home owner also confirmed that she was available to support the manager whenever needed but did recognise that she had not been regularly structured visits each month to meet with residents, carers and staff to monitor and a report on the quality of care being provided at the home. Ashlands DS0000060714.V315938.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 X X 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 X 2 X 3 X X 3 Ashlands DS0000060714.V315938.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. 1. Standard OP19 Regulation 23(2)(b)( d) Requirement The registered provider must complete an internal environmental audit of the care home with the registered manager in order to develop a clear action plan with timescales, which fully identify and address all the environmental needs of the home. Regular monthly reports must be written by the responsible individual or their appointed person and sent to the commission, with a copy to the registered manager. Timescale for action 08/03/07 2. OP33 26 08/03/07 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 Ashlands DS0000060714.V315938.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Ashlands DS0000060714.V315938.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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