Inspection on 01/12/05 for Ashley Grange Nursing Home

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Grange Nursing Home 25/10/06

Ashley Grange Nursing Home 16/06/05

Ashley Grange Nursing Home 04/11/04

Ashley Grange Nursing Home 26/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Ashley Grange Nursing Home Lode Hill Downton Salisbury Wiltshire SP5 3PP Lead Inspector Karen Mandle Announced Inspection 1st December 2005 09:30 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 Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashley Grange Nursing Home Address Lode Hill Downton Salisbury Wiltshire SP5 3PP 01725 512811 01202 875088 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) Mr Trevor Stanley Abrahams (aka Ashley) Mrs Mary Abrahams (aka Ashley) Mrs Anne Mary Cox Care Home 55 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (55), Physical disability (10), Terminally ill over 65 years of age (2) Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users who may be accommodated in the home at any one time is 55. No more than 2 service users aged 65 years and over with a terminal illness may be accommodated at any one time. No more than a total of 14 service users with dementia may be accommodated at any one time whether in the category DE or DE(E). Service users in the categories DE and PD may not be less than 55 years of age and no more than 10 persons in total may be admitted over these two categories. The Mezzanine Room must only be used by able bodied service users because there is no level floor access. The Staffing Levels set out in the Notice of Decision issued on 17 March 2003 must be met at all times. 16th June 2005 5. 6. Date of last inspection Brief Description of the Service: Ashley Grange nursing home is registered to provide nursing care for 55 older people apart from 10 people who may be under the age of 65 but over 55 years old. The home is also registered to provide care for a limited amount of people with Dementia.The home is situated in the village of Downton, which is seven miles from the city of Salisbury in Wiltshire. The home provides single room accommodation and shared rooms. The accommodation provided throughout the home is of a good standard, as are the surrounding grounds.The home is privately owned with the providers involved with the dayto-day management of the home. The Manager of the home is Mrs Alex Dempster. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection commenced at 9.40am and was completed at 4pm. The Manager Mrs Dempster was available to assist the inspector. The inspector visited with many service users during the tour of the building. The inspector reviewed care plans and other records during the course of the day. What the service does well: What has improved since the last inspection? What they could do better: Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 6 The care records should clearly provide up to date wound documentation to ensure correct treatment is provided and that the healing process of the wound is taking place. All staff will receive infection control training. 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 Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A clear admission procedure is in place and all care needs are assessed during the assessment process ensuring the home is able to fully meet the needs of the service user. EVIDENCE: The Manager Mrs Alex Dempster conducts a pre admission assessment for all service users prior to admission to Ashley Grange. The assessment procedure ensures that Ashley Grange Nursing Home is able to meet the nursing needs and social care needs of the individual service user. The assessment provides information relating to current health care needs. A record of the assessment is kept on the service users file. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, and 10 The health care needs of the service users are monitored and appropriate action taken when health care needs change. The care plans address all aspects of care apart from the wound chart documentation. The privacy and dignity of the service users is fully supported by the care team. EVIDENCE: Each service user is provided with a care plan. The inspector reviewed 4 care plans following visits with the service users. The care plans were detailed addressing long-term care needs and short-term care needs. Monthly reviews take place or when care needs change. However the wound charts should be recorded each time a wound is redressed to provide current information of treatment being provided and progress of the wound. It was also discussed with the Manager removing old information from the care plans which is no longer needed ensuring the care plan remains up to date and easy to use. All service users are registered with a GP with clear evidence of the GP visits. Health care needs of the service users are monitored and appropriate action taken by the nursing staff when health care needs changed. Care/fluid charts were in place to support service users with higher care needs. The majority of Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 10 the care charts were kept up to date during the inspection. A regular visitor to the home spoke with the inspector who was very complimentary of the care being provided at Ashley Grange and commented how helpful and supportive the staff were. The home provides general nursing care and care for people suffering with dementia. Those service users who were able to communicate were all satisfied with the care provided. Service users also confirmed with the inspector that all personal and nursing care took place in the privacy of their bedroom or bathroom this was also observed by the inspector whilst touring the building. A service user who had recently been admitted spoke with the inspector and explained how difficult it had been to move into care yet the care staff had been fully supportive and felt that he would settle into the home well. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 The activities programme has now been further developed and meets the social needs of the service users. The food provided is of a good standard and the nutritional needs of the service users are monitored. Service users confirmed they are provided with opportunities to make decisions and choices. EVIDENCE: The home has worked hard to develop the daily activities provided as required from the previous inspection. An activities person has now been employed to provide activities each afternoon, as much of the morning is taken up providing nursing and personal care. A range of activities is now in place to suit the social needs of the service users with one to one visits also taking place. A record is maintained of the activities provided and who attended what. Four service users who the inspector visited with confirmed they could do as they wished and staff would support them to make their own choices and decisions. The quality of the food provided remains of a good standard. The inspector was invited for lunch and found the meal tasty and well presented. The majority of service users were complimentary of the food provided. A 4-week menu is in Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 12 place. Service users requiring assistance with their meals were observed being provided with help from the care team on a one to one basis. The home provides two dining rooms both on the ground floor. The weights of the service users are closely monitored and where needed nutritional supplements were being provided ensuring the nutritional needs of the service users are fully met. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): A clear complaints policy and procedure is in place. An abuse policy is in place and staff are fully informed of the local vulnerable adults procedures. EVIDENCE: A complaints policy and procedure is in place, which is available in the entrance hall to the home. The complaints policy is supported by a complaints form, which is openly used by the home to log any complaints, record the action taken and outcome of the complaint. The CSCI have not received any complaints regarding this service. Three service users confirmed with the inspector that if they had any concerns or a complaint to make that they would talk to the manager. A policy and procedure is in place for dealing with any allegations of abuse, which is supported by a Whistle Blowing policy. As required from the previous inspection all staff had recently been provided with abuse awareness training and how to use local vulnerable adults procedures. The Manager is fully informed and understands the local procedures. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Ashley Grange is well maintained throughout and the cleanliness of the home remains of a high standard. The bedrooms are well furnished and personalised. Infection control measures are in place. EVIDENCE: Ashley Grange continues to provide a good standard of accommodation throughout for service users to live in. The home is well maintained and provides a safe environment for service users and the staff. Ashley Grange is furnished with domestic type furnishings, which are well maintained. A large communal room is provided on the ground floor also two dining rooms. Many of the bedrooms are single which vary in size providing a comfortable standard of accommodation. Shared rooms are available. A service user sharing a room confirmed with the inspector that it was her choice and that she was comfortable with the arrangement of sharing. Many of the bedrooms were visited which were personalised and homely. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 15 The cleanliness of the home continues to be of a very good standard. The bathrooms and communal toilets were all clean as were the carpets throughout the home. No unpleasant odours were apparent. Service users expressed how much they appreciated the cleanliness of the home. Infection control measures were in place and clinical waste appropriately managed. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, and 30 The home is able to meet the needs of the service user with the staffing levels provided. Recruitment procedures are robust and service users are protected as far as possible by the recruitment procedures. Appropriate training is provided to the staff in line with the care needs of the service users. All mandatory training is provided apart from infection control training. EVIDENCE: Due to the nursing registration of the home at least one qualified nurse is on duty at all times. During the day shift two qualified nurses are always available the rotas provided evidence of this. The qualified nurses are supported by a team of carers. Domestic staff and administration staff are also employed. The staff were observed during the course of the inspection to be organised and service users confirmed that they could get up and go to bed when they wished providing evidence that the staffing level provided met the needs of the service user group. Three employment files were reviewed all of which had evidence that appropriate police checks had been made and references obtained supporting as much as possible the safety of the service users. The employment files were of a good standard. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 17 The staff are supported with NVQ training and training has been provided in line with the care needs of the service users. All mandatory training had been provided apart from infection control. The qualified nurses are supported to attend clinical training to ensure their clinical practices are current. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 38 The Manager understands the responsibility of her role and provides leader ship to the home. The service users financial interests are safeguarded with the systems in place. Health and safety issues are addressed. EVIDENCE: The Manager Mrs Alex Dempster has now been through the registration process with the CSCI to become the registered manager of Ashley Grange. At the time of the inspection the CSCI was waiting for a CRB clearance, which has now been obtained. Mrs Dempster has worked at Ashley Grange as the Deputy Manager prior to this post. Mrs Dempster has a good understanding of her role as a manager and of the aims and objectives of the home. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 19 The administrator of the home was able to clearly demonstrate to the inspector how the home safely managed to maintain service users personal/pocket money with audit systems in place ensuring that service users financial interests were protected. The home is well maintained through out. All accidents are recorded and regularly audited. Electrical equipment is tested annually and servicing of all the hoists takes place regularly. The fire log indicated that weekly testing of the fire alarm system was taking place and that staff were being provided with fire training. Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X 3 X 4 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2b) Requirement The Registered Manager will ensure that the wound care charts are kept up to date at all times. The Registered Manager will ensure that all staff are provided with infection control training. Timescale for action 05/01/06 2. OP30 18(1ci) 01/02/06 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. Refer to Standard OP7 Good Practice Recommendations The Manager should remove old information from the care plans that is no longer needed Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Ashley Grange Nursing Home DS0000015887.V261831.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!