Inspection on 08/08/07 for Ashley Court Care Home

This inspection was carried out on 8th August 2007.

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

Ashley Court Care Home 18/05/06

Ashley Court Care Home 18/11/05

Ashley Court Care Home 16/06/05

Ashley Court Care Home 19/10/04

Ashley Court Care Home 24/05/04

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

CARE HOMES FOR OLDER PEOPLE Ashley Court Care Home Reservoir Road Kettering Northants NN16 9QT Lead Inspector Tobias Payne Unannounced Inspection 8th August 2007 08:00 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 Care Home DS0000050486.V340631.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 Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashley Court Care Home Address Reservoir Road Kettering Northants NN16 9QT 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) 01536 482777 01536 415654 ashleycourt@regalcarehomes.com www.regalhomes.com Regal Care Homes Ltd Mrs Beatrice Emma Kelly Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person in the category DE(E) can be admitted into the home when there are 38 people within the DE(E) category already in residence. By agreement 1 (one) male service user is accommodated with needs within the category of MD(E) 18th May 2006 Date of last inspection Brief Description of the Service: Ashley Court is a care home providing personal care and accommodation for 38 older people over the age of 65 years with dementia. On the day of the inspection visit there were 36 residents. Ashley Court is owned by Regal Care Homes Ltd. The home is situated in a residential area on the outskirts of Kettering town centre. It is set within its own grounds and has an enclosed garden area. There are parking facilities at the rear of the building. Accommodation is on two floors and all bedrooms are single with en suite toilet facilities. A passenger lift provides access to the first floor. There are two bathrooms on the ground floor and three on the first floor. Communal facilities consist of two lounge/dining rooms on the ground floor and a lounge and a dining room on the first floor. There is a small room on the ground floor available for private meetings. On the first floor there is a sensory room. The weekly fees on the 8/8/2007 ranged from £348.50 to £500. The fees include personal care, accommodation and meals. Extra costs not covered by this fee included chiropody £8 and hairdressing which ranged from £3.50 to £22, personal newspapers and toiletries. All information about the home including fees can be obtained from the manager. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.00 am. It was undertaken using a review of all the information available to us about Ashley Court Care Home. We spoke with 8 residents, 4 visitors, 6 staff and the deputy manager and manager as well as a representative of the company who was visiting the home. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. Comment cards were received from 9 residents and we also received an Annual Quality Assurance Assessment completed by the manager of the home. What the service does well: What has improved since the last inspection? 12 new carpets had been fitted in bedrooms and in both lounges. New curtains had been provided for the ground floor lounge. A shower room had been provided to provide choice and ease of access. New dining room tables and chairs had been provided in the first floor dining room. A sensory room had been provided on the first floor to enable residents who may be agitated to have the opportunity of being in a peaceful and calming atmosphere. Care records, questionnaires, information about the home and menus have been produced in picture form to make it easier for residents to understand the information. Supervision of staff practice has been introduced to enable the practice and approach of staff to be monitored to further ensure that high standards were maintained. Ashley Court Care Home DS0000050486.V340631.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. The summary of this inspection report can be made available in other formats on request. Ashley Court Care Home DS0000050486.V340631.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 Care Home DS0000050486.V340631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 4 and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People coming into the home receive an assessment and know all their needs can be met. There is information, which has been adapted to suit the residents to enable them to make a decision whether or not to come into the home. EVIDENCE: Since the last inspection the manager had introduced 2 service user’s guides. One specifically for residents with pictorial symbols and one for visitors. This had enabled more person focussed information to be provided to suit the residents. Information in both the statement of purpose and service user’s guide was clear and detailed. Each resident received a comprehensive assessment by the manager who obtained as much information and ensured that the home could meet all the resident’s assessed needs. Each resident received written confirmation that Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 9 the home was able to meet their needs. On arrival each resident received a welcome pack with the service user’s guide and statement of purpose. Efforts had also been made to ensure that in the case of one resident whose first language was not English that information had been obtained on the best methods for staff to communicate with the resident. One resident commented, “I was at home but I was not safe. I came here, everyone made me feel welcome and people are so kind and helpful”. The home did not provide intermediate care Ashley Court Care Home DS0000050486.V340631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A person centred approach to providing care ensures that resident’s needs are met. Suitably trained staff administer medication to ensure residents health needs are met. EVIDENCE: Since the last inspection a new care plan format has been introduced. The emphasis has been making it easier to use in pictorial form to enable residents to see their care needs. All residents had care plans, which described their health and welfare needs. Care records included admission details including a photograph for identification purposes, admission details, assessment of daily living activities, personal history, moving handling assessment, risk assessment, care plan and daily report. Care plans also included communication, “my favourite things”, “things I dislike”, daily living activities and a very detailed and person focussed care plan in pictorial form with clear, specific directions about how the resident’s needs could be met. This included diet, food, religious and cultural needs, sleep pattern, memory and orientation Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 11 and behaviour with the emphasis being on looking at the reason for behaviour and how this could be addressed. Individual preferences were also included such as what type of jewellery or clothing a resident may wish to wear. All records were in the process of being adapted to this new method. Records were dated with the signature of the member of staff and where possible the resident/ relative. Each resident also had their own key worker. Since the last inspection there had been a medication error and efforts had been made to address this. The manager and head office were now monitoring all medication every month. Staff had been retrained and there were 8 staff who gave out medication. Six of the staff were also receiving formal medication training. A medication round was observed, staff were seen to use a drug trolley, identify the resident, check the medication, give it out and sign it had been taken. There were no concerns and one the deputy managers had responsibility for monitoring medication. Throughout the inspection visit we saw residents relaxed, smiling and staff caring for them in a dignified and calm manner. Residents and visitors commented, “It is very nice here. I like the food and I am quite content thank you” and “If I didn’t like it here I would leave. Nothing is too much for the staff”. Ashley Court Care Home DS0000050486.V340631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Innovative ideas have been introduced to meet the residents’ social and cultural needs. The programme of activities is being expanded to increase choice for residents. There was a variety of nutritious food provided to ensure choices and needs are met. EVIDENCE: Staff provided activities in the home. The manager had interviewed an activities organiser and was to arrange for the person to go on a course for “activities for individuals with dementia” as part of her induction. Activities in the home included, cards, flower arranging, reminiscence, one to one activities, hand massage, visits by outside entertainers, Pets as Therapy, arts and crafts and pottery. In addition 3 residents helped in the home and one resident was encouraged to bake cakes. Since the last inspection a sensory room has been provide on the first floor off from the dining room. On the day of the inspection one resident was sat in this room relaxing with a drink and the discreet observation of a member of staff. Throughout the inspection visit there was a calm, friendly and relaxed atmosphere with staff talking to residents, residents walking Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 13 around the home on their own or with other residents, sat in small groups or with visitors. The last Environmental Health Officer’s inspection by Kettering Borough Council was on the 5/1/2007 and as a result the home was awarded 3 stars “good” award for its catering service. The kitchen would be refurbished in the future and all recommendations from the previous inspection have been addressed. Lunch was observed in the dining rooms on both the ground and first floors, which were nicely decorated with residents having lunch attended by care staff who wore plastic aprons and served food in a discreet manner. Quiet music was playing in the background and residents were talking to one another and some helping one another. No resident had any complaints about the food and it was well served and residents were not hurried. The menu was to be displayed in pictorial form in the future so that residents could see what was on the menu. In addition, new menus were to be introduced from September 2007. The new menus had been introduced following advice from a nutritionalist. Comments were “the meals are well served” and “mother enjoys the food”. Ashley Court Care Home DS0000050486.V340631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. Staff were recruited correctly to ensure that residents were protected from abuse. EVIDENCE: There was a complaints procedure displayed at the entrance to the home and each person received a copy of the complaints procedure in the service user’s guide. The complaints procedure had also been produced in pictorial form. The home and the commission had received no complaints since the last inspection. No one had any complaints about the home during the inspection. We had been made aware in March 2007 by the manager about allegations as a result of an in house investigation into bullying of staff. During the investigations other allegations had mentioned bullying towards residents. The reports have been over a period of time, not all containing dates. Adult protection issues were highlighted and Northamptonshire County Council was informed about the incident. No resident was affected and the home cooperated fully and followed the correct procedures throughout. Staff were correctly recruited with an application form, references obtained, and induction. A member of staff confirmed she had been recruited with a Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 15 Criminal Records Bureau check and a well supported induction. Staff knew about abuse and their role and training had been provided for all staff on abuse prevention in 2006 and further updates planned for 2007. Four visitors confirmed they could visit whenever they wished, always received a warm welcome, were offered refreshments and had full confidence in the staff and management. Comments were “I am always kept informed about my mother”, “”I have never seen mother so relaxed” and “mother had a wonderful birthday with a cake, balloons and such a celebration. It made her and our day”. We saw staff being polite and respectful when talking to or undertaking care duties with residents. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards19, 20, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents lived in well decorated, comfortable, clean and safe accommodation, which had been adapted to suit their needs. EVIDENCE: The home was clean, tidy, well decorated and odour free throughout. There were lounge and sitting areas throughout the home. There was a programme of redecoration and refurbishment. Residents’ bedrooms were pleasantly decorated. All bedrooms were single with an en-suite. All the residents spoke highly of the accommodation and how much they liked their bedrooms. Residents were encouraged to bring into the home small items of furniture, television, pictures, photographs and personal items. Comments were, “I love my room” and “I like my room. Everything matches which is what I like”. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 17 A sensory garden will be provided in December 2007 with raised gardens, pond, sitting areas and accessible walkways. Orientation signs had been produced to enable residents to find their room and their way around the home. Door alarms and key pads had been provided at the front door as there were concerns about the safety of residents who walked out of the home as it was close to a main road. Codes were made available and residents were able to walk around the enclosed safe garden area. We spoke with 2 domestic staff who showed evident pride in what they were doing. They said they enjoyed their work and felt valued and supported. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are protected by robust recruitment practices. Residents benefit from a staff team who are well trained and work well together and compliment each other’s skills. EVIDENCE: Many staff had worked in the home for many years. All staff spoke of working as a team. Staff, residents and visitors felt there were sufficient staff in the home. The manager monitored dependency and was able to employ more staff where required. There were no staff vacancies. Staff were recruited correctly. Each person received a supported induction over 3 days, which included adult protection and health and safety. A member of staff confirmed this and commented “I really enjoy working here”, “we are encouraged to talk and spend time with the residents”, “we have enough staff”, “I know when I go home that I have made someone’s day”. Training had included moving and handling, fire safety, infection control, food hygiene, first aid, dementia awareness, abuse prevention and health and safety. In addition 92 of staff had either achieved a qualification in care (National Vocational qualifications) or were studying for this. The home received the Investors in People award in 2005 in recognition of its training standards. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Innovative ideas to improve the lives of residents in the home have and continue to be introduced. Residents’ benefit from the positive leadership of the senior care workers and the managers. Accurate records are kept to ensure residents monies are kept safely. EVIDENCE: The manager was very experienced and full of enthusiasm and keen to try innovative approaches. She had extensive knowledge of dementia care and management. She had obtained a management and care qualification. She was supported by 2 deputy managers. Staff, residents and visitors had confidence in the manager. Staff received supervision regularly and spoke of the support received from the manager and deputy managers. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 20 There was a comprehensive company quality assurance system. A development plan for 2008 was being developed. The company made monthly monitoring visits and clear records were kept of all these visits. In addition there was a manager’s audit of weights, environment, kitchen, fire, staff supervision, resident’s personal monies, accidents, staffing levels and call system. Questionnaires had been sent out to residents again in pictorial form in Feb/March 2007 and 13 were examined. The rating varied from good to excellent. There were no negative comments. In addition questionnaires had been sent out to professionals (GPs) in May 2007. Nine responses were received. Very positive with no negative comments. A relatives questionnaire was also sent out in May 2007 and 19 returned. Specific comments were, “I find the home excellent in every way”, “a lovely care home with lovely staff. It is a shame that all care homes aren’t of the same standards as yours”, “mother is usually calm and relaxed. Any problem is sorted out quickly. Staff always friendly and supportive, kind and caring atmosphere” and “very happy with the home”. There were also staff questionnaires sent out in May 2007 with 16 responses. Comments were, ”I feel supported by my manager, she is a person I can talk to if I have any concerns and she tries her best to solve a problem”, “I am well supervised” and “I think communication is very good”. Residents’ monies were securely stored and balances found to be correct. The home had policies and procedures. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. There were no communication issues. There were no concerns about equality and diversity. An example was concerning a resident whose second language was English. On account of this efforts had been made to ensure that staff had trigger sentences in the resident’s dialect to communicate with her. The home had detailed health and safety procedures. There were also infection control policies and staff made use of alcohol hand rub bottles throughout the home to further prevent infection. Where required risk assessments had been carried out and documented. There were a range of policies and procedures available in the home relating to fire safety and fire risk assessments. Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 21 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 4 3 X 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 X 3 Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 22 NO 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. 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. Refer to Standard Good Practice Recommendations Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ashley Court Care Home DS0000050486.V340631.R01.S.doc Version 5.2 Page 24 - 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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