Inspection on 27/04/05 for Ashlea Grange Residential Home

This inspection was carried out on 27th April 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 Grange Residential Home 12/10/09

Ashlea Grange Residential Home 21/11/08

Ashlea Grange Residential Home 12/03/08

Ashlea Grange Residential Home 12/01/07

Ashlea Grange Residential Home 13/06/06

Ashlea Grange Residential Home 19/09/05

Ashlea Grange Residential Home 24/11/04

Ashlea Grange Residential Home 24/06/04

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The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

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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 Grange Residential Home Philadelphia Lane Newbottle Houghton le Spring, Tyne Wear DH4 4ES Lead Inspector Andrea Goodall Unannounced 27 April 2005 10:00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashlea Grange Residential Home Address Philadelphia Lane, Newbottle, Houghton le Spring, Tyne and Wear DH4 4ES 0191 5848159 0191 5120089 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Winnie Care Limited Applicant Manager- Mrs Michelle Butler Care Home 40 Category(ies) of OP Old Age (40) - DE(E) Dementia over 65 (12) registration, with number - PD(E) Physical Disability over 65 (8) - SI(E) of places Sensory Impairment over 65 (3) - MD(E) Mental Disorder over 65 (1) Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: (1) The Provider must address any recommendations made by the Sensory Disability Team. (2) The SI(E) and MD(E) service user categories relate to current service users only. Date of last inspection 23 and 24 November 2004 Brief Description of the Service: Ashlea Grange is a large modern, purpose built care home that provides 40 places for older people some of whom may have dementia care needs, physical or sensory disabilities. The accommodation is within 40 single rooms, all with en-suite facilities. There is a good range of sitting areas and sufficient bathrooms, some with specialist lifting equipment, to meet the needs of the people who live here. There is level access into the home, and wide corridors allow easy access by people eho use a wheelchair. The accommodation is over 2 floors which are served by a passenger lift.The home has good links with the local community. It is close to local amenities such as shops, pubs and churches and is on a direct bus route to Sunderland. The Provider, Winnie Care Limited, operates a number of other homes for older people in Sunderland and the North East region. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced visit, which took place over one day by 2 Inspectors. One Inspector spent the visit talking to the Acting Manager and senior staff, and examining records. The other Inspector spent the visit gaining the views of 16 residents and 5 visitors, examining the premises, and sampling a lunchtime meal. The Acting Manager has been in post for around 6 months. She has recently submitted an Application for Registration as the Manager and this is being processed by the CSCI. Since the last inspection the Provider has received one complaint about a staff member. This matter has been investigated by the Provider and included full liaison with the CSCI and the Social Services Department. The matter was dealt with appropriately. What the service does well: What has improved since the last inspection? There has been a significant improvement to the atmosphere in the home. Discussions with residents and staff indicated that this is due to the increase in staff support due to the lower occupancy at the home. The Acting Manager has had some time to improve care records and new recording systems are being developed to guide staff in this area. Staff spoken to stated that there is a much improved staff morale due to the change in Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 6 management, improved employment conditions, and because they feel they have more time to spend supporting residents. Staff have now had training to help them better understand the needs of people with dementia. There has been no change in staff since the last inspection and this means that residents can build relationships with staff and receive continuity of care. The standard of accommodation has been improved by new carpets and further redecoration is planned. 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. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 4. (Standard 6 is not applicable as this home does not provide intermediate care.) The assessment of potential residents ensures that only people whose needs can be met are admitted to the home. Residents receive information about the terms and conditions of their residence, but this is difficult to read. The home is registered to provide care for older people with dementia care needs and staff are now receiving suitable training to help them understand how to support and care for people with such needs. EVIDENCE: Residents are given a written contract that outlines the terms and conditions of their residence. A sample of contracts was examined. These were signed by the resident (or their representative) and by the Manager, and a copy is kept on their care file. The contract includes details of the weekly cost of their placement and the funding arrangements so that residents can see how much they contribute towards their care. The contracts are not dated and are not in clear print so are difficult to read. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 9 The majority of potential residents are assessed by Care Managers of the Social Services Department to determine whether they require a residential care service. The Acting Manager stated that the home receives a copy of the Social Services Department care plan before it is decided whether the home can meet the needs of a new resident. Senior staff of the home also carry out a brief assessment of the potential resident to consider whether the home can meet their needs, and these records were seen in the care files. The Acting Manager then sends a letter to the potential resident confirming whether or not the home can meet their needs, and copies of these were seen on care files. After a couple of months a review is held with the resident, their representatives and Social Services Department to see if the home is meeting their needs. The home is registered to provide care for people with dementia care needs and senior staff have now completed a new training course called ‘Positive Dementia Care’ and this training will be cascaded to all care staff. This is good practice, as it will help staff to understand the needs of people with dementia and how to support them. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 9. The care planning system is improving through the use of assessments, but care plan records are not detailed enough to provide staff with the right information they need to meet individual resident’s needs. Ashlea Lodge ensures that people’s personal health care needs are met but staff have not received sufficient training to support the specialist health care needs of some residents. EVIDENCE: Assessments of the residents are carried out before and after they move into the home. Their needs are identified and are put into a plan of care. These contain the goals and needs of individual residents, but don’t give enough information to staff about exactly what they should do to help residents. For example, one person with dementia needs can become aggressive but there are no guidelines for staff in the care plan about how to help the resident when this happens. In this way different staff may try different ways to support them. The Acting Manager stated that a new care plan format is going to be used, and this will be a good time to write down the instructions for staff so that residents always get the right support. Care plans are reviewed every month and these were up to date. However they do not record what has happened in past month and what support staff Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 11 have given. Residents have signed their care plans, where capabilities allow, to show that they have been included in their care planning. The Acting Manager stated that residents are also included in risk assessments e.g. for use of bed rails. However residents and any other relevant party have not signed the risk assessment record to demonstrate that they are involved in making decisions about acceptable risk-taking activities. Residents have access to healthcare professional such as GPs, Community Nursing Services and Physiotherapy. Records were seen in care files about health care visits to residents. Arrangements are in place for regular visits to the home by dentist, optician and chiropodist, although people may choose to attend their preferred private services. Following a requirement made at the last inspection the home has sought the input of specialist healthcare services for service users with diabetes. It is also good practice that staff have had training in Diabetes Care, which supports them to understand how to help people with diabetes. A random check of the medication administration records was completed. On the whole, the level of recording has improved. However, on occasions staff still forget to sign the record when they have given medication out, and this must be addressed. Therefore, omissions cannot accounted for because staff have not entered the appropriate code on the medicine administration chart. By signing the appropriate codes if staff members persistently forget to record when they have given medication out this can easily be followed up with them. Most of the medication is stored securely. However Ashlea Grange does not have an appropriate drugs fridge. The one previously used was a commercial drinks fridge and did not operate below 12°c. Medication that needs to be stored in a fridge has to be kept below this temperature. Staff have correctly discarded this fridge but now have to keep medication in the dining room fridge. This practice is highly unsatisfactory. The fridge is not locked and is easily accessible to anyone entering the dining room. Also the temperature of this fridge is not monitored and can be subject to fluctuations, as people regularly go into the fridge. Staff who are responsible for giving out medication have completed safe handling of medication courses. The staff spoken to were knowledgeable about the medication they were giving out and where to look if they were unsure of the side effects the medication. Staff demonstrated a wide range of knowledge about people’s health care needs in general. They were aware of the actions they would need to take when people became unwell. However some people living at Ashlea Grange have specific mental health needs and staff remain unclear has to exactly how to meet these needs. It has been identified at several previous inspections that staff need training around this type of need. The Manager is putting training in place but as yet all of the staff have not accessed it. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 & 15 There are insufficient social and leisure activities for residents. The lack of stimulation and social activity during the day has a negative effect on people’s sense of well-being. Meals are nutritious and offer a varied diet for residents. Dining arrangements allow residents to continue their independent living skills EVIDENCE: Lack of social activity continues to be an issue at Ashlea Lodge. Since the last inspection an activity co-ordinator has been employed but they only work on a Friday. Resident’s said that there was very little to do during the day. They said that ‘staff tried their best to organise things but they were often busy’. One person said that staff had given them some wool that day and it was the first time they had knitted in years. They said they were really enjoying this activity. Staff said that residents on the first floor were more willing to try different activities and were enjoying a dance. However it was evident that during the day there are long periods of inactivity. This lack of useful, simulating occupation can lead to residents becoming mentally and physically less able. Further activities need to be provided. Also it was suggested that the layout of Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 13 the downstairs lounge could be changed to make it possible for people to talk and socialise. A lot of the residents and relatives spoken to said that there was very little to do. A number of people said that they had not left the building for a number of months although they wanted to. They said that if relatives were around they would take them out but the staff were unable to. No regular trips are organised, and even going to the local shop was not possible. Residents said that they feel ‘fed up’ and that it is very frustrating not being able to get out. Staff should ensure that people have the chance to go to local shops and on trips. The meals provided at Ashlea Grange continue to be to a good standard. Resident’s were very complimentary about the quality of the food on offer and stated, ‘the cook is excellent and always has been’ and ‘the cook will make anything you want and nothing is a problem’. Tables were seen to be set with tablecloths, serviettes, place settings and condiments and provide a pleasant setting at a relaxed pace. Residents stated they are not rushed to finish their meal. Teapots, milk and sugar bowls were on the tables to encourage independence and some residents were seen to help themselves to tea. The food that was sampled was of good quality, hot and tasty. Relatives and residents were extremely positive about the staff. They said, ‘the staff are genuinely caring and really look after the residents’. One resident was leaving that day but their relatives said that this was only because they had pre-booked a place elsewhere. In fact they had found the staff to be exceptionally caring and really considered the feelings of their relatives and tried to give her ‘a good standard of care’. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The Complaints Procedure is advertised widely in the home so that residents are aware of how to voice any concerns about their care. EVIDENCE: The home has a Complaints Procedure, which is written in plain English, and this explains how to make a complaint and to whom. All the bedrooms have a Service Users Guide (information pack), which contains the Complaints Procedure, so that residents can refer to it at any time in the privacy of their own rooms. The Complaints Procedure is also published in the home’s Statement of Purpose, which is made available to visitors and social and health care professionals. Following a requirement at previous inspections, the home now also provides the Complaints Procedure on cassette tape so that people with poor sight can listen to the information. The Acting Manager stated that the cassette tape had been played for a resident with a visual impairment. However there is only one copy of the cassette but the home is registered to provide up to 3 places for people with visual impairment, so people wouldn’t be able to listen to it when they wanted. Since the last inspection the Provider has received one complaint about a member of staff. This matter was dealt with appropriately, involved a meeting with relevant professionals, and records have been kept about this. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 24 & 26. On the whole the home’s premises are now being maintained to a satisfactory standard. Some improvements to furnishings have been made and further redecoration is planned. The home provides a good standard of personal accommodation for the people who live here. EVIDENCE: All bedrooms have en-suite toilets, and this promotes individual privacy and dignity. Many of the bedrooms contain personal belongings, pictures, photographs and religious and cultural memorabilia. This demonstrates that Ashlea Grange encourages service users to have personal belongings around them and that their individuality is valued. Communal areas are light, airy and comfortable and provide a choice of sitting areas for service users. However the layout of lounges could be changed so that they provide more opportunity for social interaction. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 16 Additional toilets are provided near to lounges and dining rooms so that residents have easy access to toilets in all parts of the home. Toilets are fitted with appropriate grab rails and equipment to maximise residents’ independence. Winnie Care Ltd have recently purchased new carpets, following a requirement of the last inspection. Most areas of the home are in good repair but some areas now show signs of wear and tear. The Acting Manager said that plans have been made to redecorate communal areas of the home. Hot water is now running at a satisfactory temperature. Thermometers are provided in all bathrooms and showers, so that staff can check that the bathwater is at a safe temperature of about 43°C. A lot of inappropriate items were being stored in the bathroom such as mattresses and these could cause a tripping hazard. Also staff need to ensure intimate personal care items are always stored discreetly so as to reduce the embarrassment residents might feel from visitors being able to see that they have continence needs. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29. Care staffing levels have remained at minimum levels, which is sufficient to meet the current number and needs of residents. All care staff have either attained or are training towards NVQ qualifications in order to provide a well trained workforce to meet residents’ needs. There has been no staff turnover, which has led to a period of stability and continuity of care for the people who live here. Recruitment procedures ensure that all new staff are vetted before they start work here to ensure the protection of the residents. EVIDENCE: The minimum care staffing levels for Ashlea Grange are 5 care staff (including one senior) on duty throughout the day and 3 night staff (including one senior) on duty throughout the night. These hours exclude the Acting Manager’s hours, which are supernumerary. It is good practice that these staffing levels are still met. Although there has been a lower occupancy at the home recently, there are still 9 people who have dementia, confusion or mental health needs and 6 people have significant physical or mobility needs. The continued care staffing levels means that people get sufficient support with their needs. Residents commented that they get an improved service when there are less people because staff have some time to spend with them. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 18 There are also sufficient catering staff employed to provide the daily catering service for the people who live here. At this time there are only 2 domestic/laundry staff in post, but the 2 other vacant posts for domestic staff have been filled so all personnel will be in place soon. At this time 10 out of 21 care staff have attained NVQ level 2 or above, so the home falls slightly short of the National Minimum Standards for 50 of the staff to have this qualification. It is good practice that the 11 remaining care staff are undertaking training towards this qualification. In this way it is anticipated that the home will meet, and potentially exceed, this standard within the year. In discussions, staff were enthusiastic about their own professional development that will help them to provide a trained workforce to meet the needs of the people who live here. Previously the home has had a high turnover of staff. However, at the time of this visit there had been no changes to staff in the past 6 months, which means that the home has been able to provide an improved continuity of care for the residents. The Provider ensures that all checks and clearances are taken up for new staff before they start work here, so that residents are protected. Staff files were seen to include all the required records, references and qualifications of each staff member. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36 & 38. There have been improvements to the daily management of the home, which has provided clearer direction for staff. The quality of the service is not fully reviewed by the Provider to ensure the consistency of care provided. Financial systems do not ensure that residents receive their personal monies on time. Some health & safety issues present a risk of harm to residents. EVIDENCE: The Acting Manager has been in post for around 6 months. She has now submitted an Application for Registration, and this is being processed by the CSCI. The Acting Manager was formerly the Deputy Manager at another similar home for older people operated by the same Provider. She has many years experience of working in health & social care settings in a senior capacity. The Acting Manager confirmed that she is currently undertaking training towards NVQ level 4 and the Registered Managers’ Award, which are Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 20 suitable qualifications for her role and will support her in the management of the home. The Provider has a quality assurance procedure, which should be used to review the service provided. This procedure has yet to be fully implemented at the home, and the Acting Manager requires further guidance in how to carry out and record audits of the service. Residents’ Meetings are held for residents to give general suggestions and comments about the home. There are also questionnaires in the hallway for residents to give their confidential views, but these are not being completed. Residents are not made aware of the reason for the questionnaires and are not offered support by an advocate or relative to complete these. In addition, questionnaires are not printed in plain language and don’t also ask for residents’ views of the food and of staff support they receive. The outcomes of the quality monitoring system, including the views of residents, are not currently used to develop an Annual Develop Plan, so that the home has a plan of action for improvement. The Acting Manager and all senior care staff have had training in Appraisals and Supervision to equip them to carry out supervision sessions with individual staff. Suitable supervision records were seen, and staff have had some supervision sessions now. The Acting Manager now needs to plan for staff to have at least 6 supervision sessions over the coming year. The Acting Manager stated that residents or their representatives are encouraged to retain responsibility for their own financial affairs. All bedrooms were seen to have lockable facilities in which service users can securely store their personal possessions. Alternately the home will store small amounts of money for safekeeping on behalf of service users, in suitable containers, and a sample of these were checked. Records relating to transactions made on behalf of service users were up to date and include receipts and 2 staff signatures for any transactions. However where residents’ weekly fees and allowances are sent directly from the Social Services Department to the Provider, there is a delay before the Provider sends the residents’ personal allowances to them at the home. The weekly personal allowances of residents are their property and must be sent immediately to them at the home without delay. Records were seen of the monthly health & safety checks to the building. However hot water temperature checks of baths are not being recorded weekly in order to make sure that hot water remains safe for use by the people who live here. Nearly all of the bathrooms had items inappropriately stored in them, such as mattresses, hoists etc. This type of storage is hazardous as it reduces the Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 21 available turning space and can also cause a tripping hazard and is unsafe practice. Some medication is being kept in a dining room fridge. This is highly unsatisfactory, as it does not have a regulated temperature of between 5 and 8°c and some medications deteriorate and become unsafe to use if they are not stored at the correct temperature. It also means that visitors have access to people’s medication. Currently staff use latex gloves when attending to people’s personal hygiene needs. People have a high intolerance to latex and it causes a large number of people to have allergic reactions. The Health and Safety Executive advise that all latex products are replaced with similar quality vinyl products. Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x 3 3 3 x STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 2 x 2 2 x 2 Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4 Regulation 18 Requirement Arrangments must be made for care staff to receive training in the needs of people with mental health needs. (Previous requirement- timescale of 1/2/05 not met) Staff must sign medication records when medication has been given, or use the appropriate code to show the reason why medication is not taken by a resident. (Previous requirement - timescale of 24/11/05 not met). A range of activities must be made available for residents both within and outside the home. (Previous timescale of 1/1/05). Care plans must include guidelines for staff in how to support people with their specific needs/goals. The quality assurance system must put into practice to review the service provided. Residents personal monies must be forwarded to them at the home without any delay. Bathrooms must be not be used for storage, and tripping hazards Timescale for action 1/7/05 2. 9 13(2) Immediate 3. 12 16(m) & (n) 1/6/05 4. 7 15 1/8/05 5. 6. 7. 33 35 38 24 20(1)a&b 13 1/8/05 Immediate Immediate Page 24 Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 must be removed. Hot water temperatures must be checked at least weekly. 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. 3. Refer to Standard 2 7 16 Good Practice Recommendations Residents Contracts should be legible and in larger print. Residents or their representatives should sign risk assessments to demonstrate their involvement in decisions made. Copies of the Complaints Procedure on cassette tape should be made, and a copy given to those people who need information in this format and the means to listen to it at any time in the privacy oftheir bedrooms. At least 50 of the care stff attain NVQ 2 or above. The Acting Manager continue to train towards NVQ 4 and the Registered Managers Award in support of her application to be the Registered Manager. The reason for residents questionnnaires should be explained to residents, and they should be supported, where necessary, by advocates to complete the them. The supervision system should ensure that all staff have at least 6 supervisions sessions each year. Latex gloves should be replaced with vinyl gloves of a similar quality. 4. 5. 6. 7. 8. 28 31 33 36 38 Ashlea Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear 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 Grange Residential Home B52-B02 S34293 Ashlea Grange V217619 270405 Stage 4.doc Version 1.30 Page 26 - 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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