Inspection on 21/02/06 for Ashlands Nursing Home

This inspection was carried out on 21st February 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 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 Nursing Home 14/11/06

Ashlands Nursing Home 28/09/05

Ashlands Nursing Home 08/12/04

Ashlands Nursing Home 03/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashlands Nursing Home Turnpike Newchurch Rossendale Lancashire BB4 9DU Lead Inspector Jane Craig Unannounced Inspection 09:30 21 February 2006 st 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 Nursing Home DS0000022516.V280469.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. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashlands Nursing Home Address Turnpike Newchurch Rossendale Lancashire BB4 9DU 01706 217979 01706 226909 ashlandsnh@tiscali.co.uk 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 Anna Mary Marriott Mrs Anna Mary Marriott Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (21), Terminally ill (4) of places Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Under Annex 2, a maximum of 21 service users who fall in category of either OP or PD A maxium of 4 service users of the category TI within the maximum number of 21. Staffing will be in accordance with the Notice issued dated 21 May 2001 28th September 2005 Date of last inspection Brief Description of the Service: Ashlands Nursing Home is registered to provide care for people over 65 who need nursing care, people who are physically disabled and people who are terminally ill. The home is a family concern with the registered person being a first level nurse. Care is provided in a friendly atmosphere with a small staff team. The home is a former mill owner’s house, which was built in 1863. It is a grade 2 listed building, which has been adapted tastefully whilst retaining many of the original features. It lies in two and a half acres of woodlands and lawns which are well kept and fully accessible to service users. Accommodation is provided on 2 floors. The first floor can be accessed via a passenger lift. Communal areas comprise 1 large lounge and 1 small quiet room. The large dining room also has comfortable seating available. Bedrooms are mainly double, with privacy screening provided. There are no en-suite facilities. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a half day. The previous statutory inspection was done on 28th September 2005 and information on the findings of this can be obtained from the home or from www.csci.org.uk There had been no additional visits to the home. At the time of the inspection there were 17 residents living at the home. The inspector met briefly with most of the residents and six residents agreed to talk about their experiences of living in the home. Their views and comments are included in this report. Discussions were held with the registered person, a registered nurse and three other staff members. The inspector also received comments from a visiting professional. A partial tour of the premises took place and a number of records and documents were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: Residents spoke highly of the staff and the care. Their comments included: “I am very happy,” “delighted,” “can’t fault it” and “couldn’t be any better.” One resident said, “ the people who work here couldn’t be nicer.” Residents or their relatives were involved in planning and reviewing their care. The plans were clear and detailed which meant that staff had good directions for assisting residents to meet their needs. The way medicines were handled was safe and organised. The records were thorough and meant that staff could keep regular checks. Residents were happy to let staff look after their medication. One said, “it is better for staff to look after my tablets.” Staff understood the importance of residents being able to have control and choice over their own lives. Residents said they made choices about their daily routines, meals, where to spend their time and what to do. One resident said, “If I don’t want to be bothered I say so, nothing is forced on me.” Records showed that residents were given a balanced diet. The majority of residents were satisfied with the variety, choice and quality of the meals. Their comments included; “enough choice for me,” “generous portions,” and “good, plain food.” Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 6 Residents and staff said the home was very well managed. Residents talked about the high standards in the home being due to the manager. Staff said that the manager led by example and made sure that staff kept up the high standards. 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. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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 Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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): EVIDENCE: None of the above standards were assessed during this inspection. Standard 3 was assessed and met during the inspection of 28/09/05. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 Care plans were detailed and provided staff with the information they needed to understand and meet residents’ needs. The way medicines were managed provided residents with safeguards. EVIDENCE: Care plans for three residents were inspected as part of the case tracking process. Others were viewed in less detail. Care plans identified the residents’ personal, health and social care needs and how they were to be met. The directions for staff were thorough enough to ensure that care was provided in a consistent way and staff said they would read the care plan if they were unsure. Plans were reviewed every month and amended as and when the resident’s care needs changed. There was evidence that residents or their relatives were involved in the care planning process. One resident said she had signed to say that she wanted to continue to move herself independently even though there was a risk that she may fall. Correction fluid should not be used on residents’ notes. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 10 All of the residents spoke very highly of the care they received. Their comments included: “I am very happy,” “delighted,” “can’t fault it” and “couldn’t be any better.” Several residents said that the staff were very good. One said, “ the people who work here couldn’t be nicer.” A visiting professional also talked about high standards of care in the home and said the residents always seemed to be very happy. None of the residents were self-medicating. One resident said she took too many tablets to keep track and she trusted the staff to give her what she should have. Another resident said that it was better for staff to look after her tablets and she got her pain killers whenever she needed them. There were complete records of medication entering and leaving the home. Medication Administration Records (MAR) charts were complete and up to date. The stock balance of medication was recorded every day which provided a good audit tool. Controlled drugs were stored, administered and recorded appropriately. Criteria for “when required” medication were recorded on individual plans. Discussions took place as to how these could be further developed to minimise the risk of under or over medication. Medication was stored in various locations in the home. Each storage area was secure, with restricted access to the keys. Storage temperatures were monitored. There was no excess stock of medicines. Systems were in place for the safe disposal of waste medicines. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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 the following standard(s): 14 and 15 Residents were supported to make choices about their daily lives. Residents received a balanced and varied diet. EVIDENCE: Residents’ rights to autonomy and choice were built-in to the home’s policies and individual care records. Staff received training in care values and one member of staff said that the manager was “very strict about making sure residents had choice.” Residents said they felt they had sufficient control over their lives. One resident said, “I still have plenty of control and my daughter has some say.” Residents also said they could make choices about most aspects of their daily lives and gave examples of; meals, clothes and routines. One resident said, “I can choose whether or not to go down into the lounge.” Another said, “if I don’t want to be bothered I say so, nothing is forced on me.” A visiting professional talked about how she had observed staff taking time to ask residents about, “little things that matter.” Staff said they sometimes made choices on behalf of some residents. Their choices would be based on information from relatives and what staff had learnt about residents’ likes and dislikes. The records of meals showed that residents received a varied and balanced diet. Residents could have drinks and snacks at any time during the day. Cold Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 12 drinks and fresh fruit were available for residents to help themselves. The cook said that menus were due to be reviewed quite soon and that residents would have input into this. There was only one resident who said she was, “not keen on the food.” Other residents were satisfied with the quality and variety of the meals. One said, “the meals are pretty good on the whole.” Other comments included, “enough choice for me,” “generous portions,” “good, plain food,” and “the butter is particularly good.” Special diets were catered for and liquidised meals were attractively served. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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 the following standard(s): 16 Residents were confident that any complaints would be dealt with appropriately but there was a lack of clear records to substantiate this. EVIDENCE: The complaints procedure was prominently displayed. The procedure was clear and included all of the required information. All but one of the residents spoken with said they had never had to make a complaint but all were confident that if they did the manager would deal with them properly. The other resident said, “I had to complain in the beginning but it was sorted out straight away.” Staff knew how to receive and handle complaints in accordance with the procedure. However, care records for one resident showed that a relative had made a complaint to staff which had not been recorded in the complaint log. There was no record of actions taken by staff or the outcome of the complaint. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: None of the above standards were assessed during this inspection. Standards 19 and 26 were assessed and met during the inspection of 28/09/05. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: None of the above standards were assessed during this inspection. Standards 27, 28, 29 and 30 were assessed and met during the inspection of 28/09/05. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 16 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 and 38 The home was very well managed, which benefits residents and staff. Regular training in health and safety topics provided safeguards for residents and staff. EVIDENCE: The registered person managed the home on a day to day basis. She is a registered nurse who has a palliative care qualification and has many years experience of caring for older people and people with terminal illness. The registered person also holds an NVQ level 4 in management. The staff and residents all said the home was well managed. A number of residents said that the registered person was responsible for the high standards in the home. One said, “everything is done properly and that is down to Mrs Marriott.” Another commented that the home was well run and “everyone knows what they are doing.” Staff said that the registered person, “led by example”, and made sure that everyone kept up the high standards in the home. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 17 Following a previous recommendation a system had been introduced to flag up when training in safe working practices was due. Records showed that training was up to date. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X X X X 3 Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP16 Good Practice Recommendations Correction fluid should not be used on residents’ notes. Records of complaints should include the action taken to resolve the complaint and the outcome. Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Ashlands Nursing Home DS0000022516.V280469.R01.S.doc Version 5.1 Page 21 - 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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