Inspection on 28/09/05 for Ashlands Nursing Home

This inspection was carried out on 28th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 21/02/06

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 Announced Inspection 28th September 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashlands Nursing Home DS0000022516.V254151.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. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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.V254151.R01.S.doc Version 5.0 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 8th December 2004 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.V254151.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which meant that the residents and staff were told beforehand when the inspector would be arriving. The inspection took place over one day. At the time there were 18 residents accommodated in the home. The inspector met most of the residents. Seven residents were able to talk about their experiences of living in the home and their views and comments form part of this report. Five residents also completed comment cards before the inspection. Discussions were held with the registered person and four other members of the staff team. 14 relatives had returned comment cards and letters. The inspector spoke with four other relatives during the inspection. All their comments were very positive. A tour of the premises took place and a number of documents and records were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. There had been one additional inspection to the home in response to an anonymous complaint. Proprietors and staff co-operated fully throughout the investigation. The issue raised by the complainant was completely unfounded and the complaint was not upheld. What the service does well: The registered person made sure that residents were assessed before they were offered a place at the home. Residents were then sent a letter explaining what their assessment had shown and what care they could expect when they moved in. This made sure that residents were clear about the level of care they would receive. Residents and their relatives said that staff looked after their health very well. Several commented on the quality of care. One said the care was, “second to none.” Relatives were also happy with the care and one commented that Ashlands “provided the highest standard of care.” Care records showed that residents’ health was monitored and referrals were made to other professionals when necessary. Residents said they liked living at the home. There were good relationships between the residents and staff, which contributed to the warm and friendly atmosphere in the home. Residents and their relatives described the registered person and staff as kind, caring, professional and loving. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 6 Residents said that staff respected their privacy and treated them with dignity. Several said that staff were polite and respectful. Relatives also commented on the attitude of staff and one wrote that staff; “bestow kindness, affection and dignity on all of the residents.” 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.V254151.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 Ashlands Nursing Home DS0000022516.V254151.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): 3 and 6 The admission procedure was very thorough and ensured that staff understood the resident’s needs and how they were to be met. EVIDENCE: All residents were assessed prior to their admission. Three files were viewed as part of the case tracking process. The files contained assessments from various professionals. The registered person also conducted an in-depth assessment, which highlighted the prospective resident’s strengths and needs. The resident and/or their relatives were fully involved in the process. The resident received a letter confirming that their needs could be met at the home. The letter was individual to the resident and identified their assessed needs and the actions to be taken to meet these. Staff confirmed that they were fully apprised of the new resident’s care needs before they came into the home. The home did not provide intermediate care. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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, 8 and 10 Care plans were detailed and provided staff with the information they needed to understand and meet residents’ needs. Staff met residents’ healthcare needs with support from outside agencies as necessary. Care was provided in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: Care plans were drawn up from the resident’s assessment of needs. Plans were detailed and provided staff with clear directions as to how residents’ health, social and personal care needs were to be met. The resident and/or their relative could be involved in the care planning process if they wished. Care needs were reviewed regularly and plans were updated as and when changes occurred. Staff said they read the care plans regularly and were informed verbally if there were any changes. Care files contained risk assessments for moving and handling, nutrition, falls, pressure sore risk and potential risks to the individual, for example, use of bed rails. Plans were drawn up where risk was identified. Ongoing physical and psychological health care needs were monitored very well and plans showed that care and treatment were evaluated and changed as necessary. Referrals Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 10 to outside agencies were made as required. Visits from other professionals such as doctors, district nurses, dieticians, speech and language therapists, opticians and dentists were recorded. Residents and their relatives said they received excellent care at the home. One resident said that the staff were very good at making sure she took her supplements to help with weight gain. Another said the care was “second to none.” Relatives commented that Ashlands “provided the highest standard of care,” and one said, “my mother is looked after with courtesy, concern and professionalism.” Relatives were also pleased that they were kept informed and felt consulted about the resident’s progress and care. One said, “they look after (his) health very well, the slightest thing they let me know.” Throughout the course of the inspection staff were seen to speak with residents in a respectful, polite manner. Care plans made reference to providing care to maximise the resident’s privacy and dignity. Staff received training in core values and said this was reinforced on a day-to-day basis. They gave examples of how privacy, dignity and independence were maintained. Residents said that staff respected their privacy. There were privacy screens in shared rooms. One resident said that staff knew how important her independence was and that they gave her as much as she needed. Relatives also commented on how core values were maintained. One relative said she was always given privacy when she visited her husband. Another wrote that staff, “bestow kindness, affection and dignity on all of the residents.” Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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): 12 and 13 EVIDENCE: Routines were flexible and residents’ individual wishes were respected. Residents said the home lived up to their expectations. One resident said she hadn’t wanted to come in at first but she was “very, very happy here and couldn’t be anywhere better.” Another said “it’s not home but a good second best.” Residents’ social interests were recorded on their initial assessment and additional care plan. The registered person said there were some regular activities, including a weekly movement to music group, a fortnightly sing-along with an organist and a monthly church service. Special events were celebrated. Some residents pursued their own interests with help from the staff. Many residents preferred to stay in their rooms. One commented, “I greatly appreciate that I am allowed to spend as much time as I want in my own room.” Another resident who stayed in her room said “staff spend time with me when they can.” All residents spoken with said the level of activities provided by the home was sufficient. There was an open visiting policy and any special wishes residents had about visiting were recorded on their care plans. Residents said they were pleased with the visiting arrangements and were always able to receive their families in Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 12 private. One said “I have lots of visitors any time.” Relatives said they felt very welcome in the home. One said “the matron looks after visitors as well as the residents.” One relative who came in to assist with her husband’s personal care said “I am always made to feel right, not in the way or anything.” There were visits from local schools, churches and other community groups. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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): 18 Staff had a clear understanding of adult protection issues, which safeguarded residents and meant that any alleged incidents would be dealt with appropriately. EVIDENCE: Adult protection issues were covered during induction training. Half the staff had received update training and a further session was planned for next month. Written guidance and policies on how to detect and report adult abuse were available to staff and management. Staff who had received update training showed a clear understanding of their roles and responsibilities and how to report any allegations. They were familiar with the whistle blowing policy. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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): 19 and 26 The home was clean and well maintained and provided residents with a safe environment. The standard of décor and furnishings provided residents with comfortable and homely place to live. EVIDENCE: The home was a large detached 19th Century property. It had been adapted to make it fit for purpose and many of the original features had been retained. The fabric of the building was well maintained. There was a good standard of décor and furnishings throughout. There was a programme of redecoration and refurbishment. The lounge and several other areas had been redecorated and re-carpeted since the last inspection. The extensive grounds were well kept and accessible to all residents. Several residents commented on how much they liked the home and their bedrooms. One said, “the rooms are beautiful; airy and bright.” Another said she was happy with her room and that it had everything in it she needed. At the time of the inspection the home was clean, tidy and free from offensive odours. Residents said the home was always kept clean. One relative wrote, Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 15 “Ashlands is always clean and there is never a smell, quite an achievement.” The laundry was sited in the basement, away from food preparation areas. Washing machines had the necessary programmes to meet disinfection standards. Residents were satisfied with the laundry service, which one said was “efficient”. There were procedures for the control of infection and staff received training on induction. There were sufficient hand-washing facilities throughout the home. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 There were sufficient staff on duty to meet the needs of the residents. Residents benefited from a stable and qualified staff team. Recruitment practices provided safeguards for residents. EVIDENCE: Staffing rosters provided an accurate reflection of the staff on duty at any given time. The registered person stated that there were minimum staffing levels but these were increased in accordance with residents’ needs. Staff confirmed this. All residents and relatives said they thought there were sufficient staff on duty at all times. One resident said, “if I press the buzzer someone comes straight away.” Relatives said there was always a member of staff to see them. One said “they make time for you.” Residents all said they got on well with the registered person and the staff. The various comments included, “the staff are great,” “very helpful,” “staff are very good,” “everyone’s nice” and “lovely helpers.” Relatives described the staff as caring, polite, kind and thoughtful. Recruitment practices had improved since the last inspection. The files of three recently recruited staff showed that all pre-employment checks were conducted. The required information and documents were retained on files. Systems were in place to verify the registration status of trained nurses. There were low levels of sickness and absence. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 17 Staff said there were good opportunities for training. The induction training programme met the National Training Organisation specification. The registered person confirmed that 50 of care staff held an NVQ level 2 or above. Other training relevant to the needs of the resident group was available. Courses included; wound care, catheter care, continence, dementia care, swallowing difficulties and pressure sore risk. One member of staff said that there were lots of in-house lectures that kept staff up to date. A trained nurse said there was ample training to ensure she fulfilled the requirements of her registration. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38 Systems were in place to review and improve the quality of care. Residents’ finances were handled in accordance with their wishes. Policies and practices safeguarded the health and safety of residents and staff. EVIDENCE: The home held the Investors in People award. The Blue Cross quality assurance scheme was adopted in the home. This comprised a self monitoring tool based on the National Minimum Standards. This was reviewed annually and any shortfalls actioned. The last resident survey was 2 years old. The survey had not identified any areas for improvement. The registered person planned to repeat the survey in the future. Surveys were available for relatives and professional visitors to the home. All those returned were very positive. Staff views were sought through supervision and staff meetings. Residents, visitors and staff said that they could make suggestions to the registered person at any time and they would be listened to. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 19 The registered person did not handle any finances on behalf of residents. The person responsible for doing so was identified on the resident’s care plan. Residents were offered lockable facilities and their ability to hold the key was recorded on their plans. The registered person confirmed that there were adequate facilities to store any money or valuables handed over for safe keeping. There were health and safety policies and a designated health and safety representative. Staff received training in safe working practice topics during their induction. The registered person confirmed that most staff had received update training. However, there were no systems to highlight when moving and handling, infection control, first aid awareness and food hygiene training was due and some may be out of date. Fire safety training was up to date. The fire risk assessment was reviewed and updated. Records of fire drills were kept. Fire alarms and emergency lighting were checked regularly. Servicing and maintenance of installations, appliances and equipment was up to date. The registered person confirmed that there was always a qualified first aider on duty. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 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 X X 3 X 3 X X 2 Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 21 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 Refer to Standard OP38 Good Practice Recommendations Systems should be in place to identify when staff training in safe working practice topics is due. Ashlands Nursing Home DS0000022516.V254151.R01.S.doc Version 5.0 Page 22 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.V254151.R01.S.doc Version 5.0 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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