Inspection on 18/10/05 for Ashlea Court Residential Home

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashlea Court Residential Home 14/05/07

Ashlea Court Residential Home 19/06/05

Ashlea Court Residential Home 12/11/04

Ashlea Court Residential Home 27/05/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashlea Court Residential Home Archer Road Farringdon Sunderland SR3 3DJ Lead Inspector Mr Lee Bennett Announced Inspection 09:30 18th & 21 October 2005 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 Ashlea Court Residential Home DS0000034309.V251742.R02.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. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashlea Court Residential Home Address Archer Road Farringdon Sunderland SR3 3DJ 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) 0191 5282526 0191 528 2532 Winnie Care Limited Ms Gillian Margaret Reed Care Home 40 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (22), Old age, not falling within any other of places category (28), Physical disability over 65 years of age (8), Sensory Impairment over 65 years of age (5) Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The one specific service user in the DE category will relate to the current service user only. Staff must receive suitable training regarding the needs of service users with early onset dementia within two weeks of the service user`s admission. Staff must receive suitable training regarding the needs of service users with early onset dementia within two weeks of the service user`s admission to the home. 13th April 2005 Date of last inspection Brief Description of the Service: Ashlea Court is care home, providing personal care for up to 40 older people, some of whom may have dementia related needs. Nursing care is not provided, but District Nursing services can be arranged where necessary. It is a purpose built care home with accommodation provided over two floors, with level access throughout. A lift provides access between the two floor of the home. There is a garden area in front of the home, which includes a paved seating area. The home is situated on the outskirts of Sunderland near to local public transport links. It is also situated near to a range of local facilities, including a doctors surgery, shops, pubs and places of worship. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over 8 hours and was a scheduled announced inspection. The inspection included a separate review and analysis of the preinspection questionnaire, and comment cards received from service users and their relatives / representatives before, during and after the inspection. A tour of the building took place, and a sample of staffing and service users records was inspected. Service users, staff, the registered manager and visitors were spoken with, and the inspector took a meal with service users on the first floor. The judgements made are based on the evidence available to the inspector on the day of the inspection, the pre-inspection questionnaire supplied by the prospective manager and the comment cards completed by service users and their relatives. What the service does well: Staff were observed to have a good rapport with service users, and to make visitors welcome. Service users comments included: • • • • “I’m settling in.” “I’m quite content here.” “You cannot beat it here.” “The food’s always nice. … You do wonderful meals here.” Several relatives also commented on the quality of care provided (by directly to the inspector, or in comments on the questionnaires). Positive comments included: • • • “My (relative) has been treat very well and the family are pleased with staff and everybody concerned …”) “My (relative) is very content with all aspects of his current accommodation and care.” “My (relative) is always clean and tidy as are her room and other facilities whenever I visit.” Relatives appear to be made welcome, and one regularly shares meals with his wife in the home. Service users made positive comments about the food provided, which was observed to be well presented, nutritious, and to include fresh fruit and vegetables, as well as fortified foods. Staff are available to provided 1 to 1 support where needed. Service users also benefit from purpose built accommodation that includes an en-suite toilet and hand wash basin. The home is effectively managed. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 6 Of the 25 comment cards received from relatives, 22 stated that they were satisfied with the overall care provided. What has improved since the last inspection? What they could do better: Some relatives commented that there was little in the way of activity on offer in the home, a comment shared by about a quarter of service users who used the questionnaire. Three quarters of the questionnaires returned indicated that there were suitable activities provided. Specific comments included: • • “No activities for residents, also no outings which we were told there was when my (relative) took residence in the home.” “…my biggest complaint is the lack of stimulation for residents. … The less older people do, the less they want to do so there is a lot of apathy in the place. An occasional entertainer is hired … There are few outings (a specific activity is referred to as being enjoyed). Things like a sing-along or a memory lane evening would be great.” A worker employed across a group of five homes, including Ashlea Court, was employed (providing activities support for 1 day a week) however this person has since left and the post remains vacant. Although periodic activities are documented the take up is variable, and occupation and stimulation for service users is an area that requires review. Many service users, particularly those living on the first floor of the home, have little opportunity to leave the home, and there is no safe provision for service users to spend time outside. Therefore professional dietary advice needs to be obtained regarding suitable dietary supplements where service users are not exposed to natural light and may therefore be deficient in vitamin D. The provision of a means for service users to safely access the garden / grounds of the home is an outstanding requirement. Two comment cards were received expressing concern about the standard of cleanliness and accommodation in the home, which although generally adequate, lacks attention to detail, such as cleaning in less accessible areas, Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 7 door kicker plates, worn seating, and heavily stained carpets in some areas of the home (particularly leading from the kitchen to the dining room). The laundry area is well organised, clean and tidy, but has only one washing machine to deal with all of the home washing needs, including soiled clothing. There is no sluicing facility. This should be reviewed following appropriate advice being sought, and an additional washing machine provided to reduce the risk of cross contamination. 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. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 8 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 Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 9 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): Standard 6. Intermediate care is not provided at Ashlea Court. EVIDENCE: At the time of the inspection, the aim and purpose of the home was to offer permanent placements only. Short term placements are also offered, however this is not for the purpose of rehabilitation. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7. Each service user has a care plan in place, that reflects their observed needs. This can assist in guiding care practice and ensuring consistency where necessary. EVIDENCE: The service users’ care plans that were inspected provide guidance to staff on those need areas observed by the inspector, such as assistance with eating and challenging behaviour. These have been periodically evaluated, and daily progress notes are also written up by care staff. Ashlea Court Residential Home DS0000034309.V251742.R02.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): Standard 15. Service users receive an appealing and varied diet, with adequate levels of support when required. Therapeutic diets, particularly with regard to vitamin D, need to be reviewed for those service users who do not have access to outside space and activities. Where provided this can contribute to the improved general health and wellbeing of service users. EVIDENCE: Staffing levels at mealtimes (on the first floor) have been increased by the manager altering staffs’ own meal breaks. This has allowed for an increased level of one to one support being offered at this time. Staff must ensure that support with personal hygiene is also offered before meal times, such as with hand washing, as one relative commented that this was an area of concern. A choice based menu is available at each mealtime, which includes fresh fruit and vegetables. Service users are offered drinks between meals. The incorporation of finger foods into the menus is still to be undertaken. Many service users do not have the opportunity to leave the confines of the home, and are therefore not exposed to natural sunlight. This means that they may be deficient in vitamin D, and appropriate dietary advice must be sought in this respect, based on a review of individual service users needs, diet and their opportunities to leave the building. This is a requirement of this report. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 12 Some service users use adapted crockery, such as lipped bowels, or plates with removable guards. This can assist and promote their independence at meal times. Ashlea Court Residential Home DS0000034309.V251742.R02.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): Standard 16. A clear complaints procedure is available in the home, which can enable service users’, and their relatives to raise issues regarding the operation of the care home. EVIDENCE: Service users and relatives indicated that, on the whole, they were aware of the home’s complaints process. Of the 29 comment cards received from service users 27 stated that they were aware of who to speak to if they were unhappy with their care. Similarly 20 relatives stated that they were aware of the home’s complaints procedure. 5 were not. Several stated that they had accessed this and the homes own records indicate that 3 complaints have been received during the last twelve months. There have been no complaints regarding the home passed on to the Commission during the past twelve months. Ashlea Court Residential Home DS0000034309.V251742.R02.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): Standards 20, 23 and 26. Service users have access to safe and comfortable indoor space. Access to outdoor space is dependant upon staffing support. Service users’ bedrooms suit their needs. This can enable sufficient space for manual handling tasks, and improved levels of privacy by access to individual en-suite facilities. The home is generally clean, but increased attention to detail in cleaning routines is required. Laundry facilities are in need of review. Further attention to this can help ensure that a positive image for service users is promoted and the risk of cross infection is limited. EVIDENCE: Service users have access to a range of shared spaces, including a dining room and two lounge areas on each floor and a conservatory on the ground floor. There is a designated smokers lounge on the first floor. The home benefits from substantial garden areas, however access to these areas for service users who are confused, or who have dementia, is dependant upon staff support. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 15 Service users are provided with individual bedroom accommodation, each with their own en-suite toilet and hand wash basin. All bedrooms exceed 10 square meters in size, and many have been personalised, with ornaments and furnishings, to suite service users own tastes. Domestic staff work hard to maintain a clean and hygienic environment, however attention to details, such as kicker plates, under bath seats (and associated gaiters), inside drawers and, so on is required. High dusting and hovering under beds and behind furnishings is evident. In the first instance the manager should review the work schedules and monitoring arrangements for domestic activities. This is a recommendation of this report. The laundry area was found to be clean, well ordered and well organised. Currently there is one industrial; washing machine and tumble dryer for the home. There are no separate sluicing facilities and all laundry, including soiled clothing, bedding and towels, along with kitchen laundry are dealt with in the same machine. The adequacy of this needs to be discussed with the Environmental Health Officer and their recommendations implemented. This is a requirement of this report. Ashlea Court Residential Home DS0000034309.V251742.R02.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): Standards 28, 29 and 30. Service users are protected by the home’s recruitment procedures. This can help ensure that unsuitable candidates do not gain employment in the home. Staff receive training relevant to their job roles. This can contribute to their understanding of service users’ needs and competence to undertake their job. EVIDENCE: Staff records indicate that the manager receives two references and an ‘enhanced’ Criminal Records Bureau disclosure as part of the staff recruitment process. Prospective employees are also asked to complete a medical declaration, and questioned about any gaps in their employment record. Staff have received training on a range of topics over that past twelve months, including that in relation to Dementia care, fire safety, adult abuse and manual handling. The manager has indicated that 54 of the care staff team have attained an NVQ qualification in care, at level 2 or higher. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 17 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): Standards 33, 34, 35 and 38. Quality assurance arrangements are in place, which include the views of service users and their relatives. Accounting arrangements indicate that the home is financially viable. Centralised arrangements for the handling of service users’ personal savings does not serve their interests well and may put them at risk of being financially disadvantaged. The health, safety and welfare of service users is promoted and generally well protected. EVIDENCE: The registered manager has compiled a quality assurance file, which incorporates the views of service users and their relatives. Service users’ views are also sought by periodic meetings, where issues such as food, care, the building and the spending of the residents’ fund are discussed. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 18 Some service users living in the home have their ‘personal allowance’ (sometimes referred to pocket money) managed centrally by Winnie Care. The income from this is held within one of two pooled bank accounts, one of which accrues interest, the other not. There is no mechanism to allocate and pay this interest to service users, either current or past. There is no clear means of reconciling the various means by which the money is held (bank accounts, petty cash system and individual cash floats). On occasions service users may be indebted to this account, consequently borrowing from other service users without their permission. The Commission is currently working with Winnie Care and Sunderland Social Services to resolve the issues surrounding the operation and management of these accounts. In the mean time, no further service users are to have their savings or personal allowance paid into accounts operated by Winnie Care. This is a requirement of this report. Arrangements to assess, review and resolve health and safety hazards are operated in the home. Staff receive training on health and safety related topics, such as manual handling, fire safety and infection control. Several unsuitable or unsafe dining chairs (in terms of their design, and the needs of service users) are still to be replaced. These are reported to be on order. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 2 X X 3 X X 2 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 1 X X 2 Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP15 Regulation 12(1)(a) Requirement The registered manager must review the availability of therapeutic diets, after seeking professional dietary advice, for those service users at risk of vitamin D deficiency. This is a new requirement. The registered manager must provide adequate facilities for those service users accommodated on the first floor of the care home to safely and freely access the gardens and grounds. The previous action plan dates for this requirement were 24/7/05. The registered person must not deal with any further service users personal allowance payments through business or pooled banking arrangements. This is a new requirement. The registered manager must seek the guidance of the local Environmental Health Officer in respect of the adequacy of current sluicing and laundry arrangements, and act upon this advice. This is a new requirement. DS0000034309.V251742.R02.S.doc Timescale for action 30/01/06 2 OP20 23(2)(o) 30/03/06 3 OP35 13(6) 18/11/05 4 OP38 16(2)(j) 30/01/06 Ashlea Court Residential Home Version 5.0 Page 21 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 OP26 Good Practice Recommendations The registered manager should review cleaning routines and monitoring arrangements in the home. Ashlea Court Residential Home DS0000034309.V251742.R02.S.doc Version 5.0 Page 22 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Ashlea Court Residential Home DS0000034309.V251742.R02.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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