CARE HOMES FOR OLDER PEOPLE
Ashley Court Ashley Court 251 Penn Road Penn Wolverhampton West Midlands WV4 5SF Lead Inspector
Pat Scott Key Unannounced 4th July 2006 10:00 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 Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ashley Court Address Ashley Court 251 Penn Road Penn Wolverhampton West Midlands WV4 5SF 01902 335584 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) www.ashleycourtcare.co.uk Ashley Court Care Ltd Narinder Kaur Bachra Care Home 21 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (21) of places Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No more than 6 service users may be admitted having mild dementia (DE). 13/10/2005 Date of last inspection Brief Description of the Service: Ashley Court care home is providing personal care and accommodation for eighteen older people. The home is located on the Penn Road, one and half miles from Wolverhampton city centre. It is close to the local shops and amenities. The home is a large semi-detached property that was adapted as a residential care home in 1981; and further extension and improvements have been made over the years. The accommodation consists of single occupancy rooms with en-suite facilities, communal sitting areas and dining room. There are gardens and a patio area at the rear of the building. There is ample car parking space at the front of the building. An application is being considered to increase the bedrooms by 3 and to provide further communal space and facilities. Ashley Court Care Ltd make their services known to prospective service users in: The Statement of Purpose and Service Users Guide. The inspection report is mentioned in the statement of purpose and how a copy can be obtained. The care home rates are reviewed annually and service users are notified one month in advance. The only additional charges to service users are for hairdressing and chiropody. This is clearly laid out in the terms and conditions. Fees for Ashley Court as of 1st April 2006 are: £336 to 385. All service users pay monthly. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion, where possible, with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection?
Requirements made at the previous inspection had been fully addressed. The manager has gained the required qualifications and is competent to run the home. Through conversation she demonstrated she works continuously to improve services and provide an increased quality of life for service users. The manager is very service user focused, leads and supports an enhanced staff team providing them with improved training and supervision. She also keeps staff up to date with professional research and literature, in both the social care and clinical fields. This style and approach to management aims to pursue future improvement in all aspects of the service. Service users felt that since the new owner had taken over that the atmosphere in the home had improved. One person stated that “the place is a lot brighter and the decoration more to their liking”.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 6 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. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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 Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: Service users spoken with stated that it was a member of their family who made the choice as to which home they would move into. They confirmed that they were aware that their family had received information from the home about its services beforehand. Ashley Court is registered to admit people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. Staff have access to training materials.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 9 Care files contained full needs assessments that were conducted prior to service users being admitted. These documents confirmed that the assessment had been conducted professionally and sensitively and had involved the family or representative of the prospective service user. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a service user receives, is based on their individual needs thus promoting good health. Staff have a good attitude to their work and the principles of respect, dignity and privacy are put into practice. EVIDENCE: Discussions with service users showed that the home has a strong ethos of involving service users in all aspects of their life. The care plans that were read were clearly written and included an element of risk assessment. Bed rails were seen in use with no formal assessment of risk having been undertaken. Information from the initial assessments had been written into the plan of care. Care plans are reviewed monthly by staff. Care plans demonstrated that staff actively promote the service users’ right of access to the health service both within the home and the community.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 11 Appointments are planned or arrangements are made for professionals to visit frail service users. Wherever possible continuity of care for the service users’ declining state of health is assured. District nurses are called upon to assist with clinical help, equipment and advice where necessary. The manager promotes the keyworker system robustly so that relationships between key staff and individuals is enhanced. The home operates an efficient medication system and staff spoken with understood their roles and responsibilities. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose their life style, social activity and keep in contact with family and friends. Social and recreational activities meet service users’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Service users, who were able to give an opinion, were very complimentary about the food provided. They were not all able to state what they had chosen for lunch but some said that staff come round and ask them their preference from the menu each day. The home has a main kitchen that meets the requirements of the Environmental Health Office. Service users are enabled to enjoy a full and stimulating life style with a variety of options to choose from. A record of activities participated in is kept and photos displayed. Service users were seen sitting outside chatting to staff and visitors and in other communal areas within the home.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 13 Some service users stated that they preferred to sometimes sit quietly in their room and that staff respected this. The home now provides a hairdressing room in the new extension. The manager discussed the possibility of providing computer equipment so that service users who have distant family can keep in contact via e-mail. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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 the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to a robust, effective complaints procedure that enables them or their supporters views to be listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. EVIDENCE: The CSCI has not received any complaints about the home. Nor have their been any adult protection issues. Service users were seen to speak easily to staff and were comfortable in their company. Staff are trained in communicating with people with dementia to ascertain their well being. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Rooms entered into were personalised according to individual wishes and tastes. Communal areas were clean and comfortable. Service users have access to a large garden and patio area which is to be improved after the building works have been completed. The laundry is equipped to deal with ordinary but not soiled linen. Staff implement procedures to minimise cross infection but improving this facility could reduce the risk further. The manager stated that this aspect of the service had been identified as an area for improvement.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfill the aims of the home and meet the changing needs of residents. EVIDENCE: The files of staff were seen which showed that robust recruitment practices are carried out. Staff records were seen regarding induction and training. The induction standards having been amended to meet those for ‘Skills for Care’. Staff confirmed that training is provided and there are many equal opportunities to improve themselves for the benefit of service user care. Equality and diversity training was attended by two staff in February 2006. Service users commented that they feel safe with the staff caring for them and they felt that the home employs people that are capable of carrying out their care duties. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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): 31,32,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The ethos of the home is based on openness and respect with effective quality assurance systems developed by a qualified, competent manager to achieve good outcomes for service users in all areas of care. EVIDENCE: The manager/owner has completed the required qualification to meet he standards. She organises training events and updates staff to complement their roles within the home. Through discussions with the manager, she demonstrated that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the service users living at Ashley Court. There is an emphasis on continually improving her performance through research into best practice in elderly and dementia care.
Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 18 The home actively encourages service users, where able, to manage their own money and one service user likes to go out daily to the local shop. Equality and diversity for service users were seen to be promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that service user satisfaction is at the heart of the service. The home keeps records to show that the health and safety of service users is promoted and protected. Service users spoken with were very complimentary about the manager and staff in the home. They certainly knew who they were by name and looked at ease in their presence. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 3 3 Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 OP26 1 OP26 13(3) Standard Regulation 13(3) Requirement The registered provider must install a washing machine with a sluice wash to minimise cross infection. The registered provider must provide separate hand washing facilities in the laundry room. Timescale for action 04/10/06 04/10/06 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 OP7 Refer to Standard Good Practice Recommendations The registered provider should demonstrate that the use of bed rails has been as a result of a robust risk assessment. Ashley Court DS0000058006.V302259.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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