CARE HOMES FOR OLDER PEOPLE
Ashley House 155 Barlow Moor Road Didsbury Manchester M20 2YA Lead Inspector
Ann Connolly Unannounced Inspection 17th January 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 House DS0000021531.V278753.R01.S.doc Version 5.1 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 House DS0000021531.V278753.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ashley House Address 155 Barlow Moor Road Didsbury Manchester M20 2YA 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) 0161 445 3776 Mrs Deborah Reynolds Ms Carmel McHale Mrs Deborah Reynolds Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (17), Physical disability (1) of places Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of service users accommodated is 18. That one named service user is accommodated who is under the age of 65. That the category of registration reverts solely to older people (OP) when this service user reaches the age of 65 or leaves the home. 23rd June 2005 Date of last inspection Brief Description of the Service: Ashley House is a privately owned residential care home providing personal care and accommodation for 18 older people. The home is located in the Didsbury area of Manchester and is within easy reach of Manchester City Centre. The area is well served by public transport to the neighbouring areas of Stockport and Chorlton. In addition, the home is well positioned for local amenities such as shops, Didsbury shopping centre, hospitals and Manchester airport. The home is a large Victorian detached property that stands in its own grounds. Well-maintained gardens provide pleasant outdoor facilities. Parking is at the side of the building and there is access to a large car park to the side of the building. The accommodation comprises of twelve single and three double bedrooms. All rooms have a wash hand basin and are individually furnished with some residents bringing their own furniture into the home. There are two pleasant lounges on the ground floor and these were decorated to a satisfactory standard. A separate dining room is available where seating is arranged in small group setting of four. Accessible toilets and bathrooms are located on both floors near to bedrooms and living rooms. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours on 17 January 2006. During the inspection, time was spent talking to half of the residents, staff members, the owners/manager and one visiting professional, to find out their views of the service. Time was also spent examining medication, the care plan files, health and safety issues and a tour of the building also took place. Comments from residents about the care they receive were very positive, and this has remained the same over the past two inspections, indicating continuity in the standard and quality of services offered in this home. During each inspection, the providers have demonstrated a positive commitment to meeting any requirements in order to make improvements in the services they deliver to residents in the home. During this inspection only a selection of the National Minimum Standards were assessed. In order to gain a full picture of how the home meets the needs of the residents, this report should be read together with the previous and any future reports. What the service does well:
Ashley House provides a homely and relaxed environment for the residents living there. All residents spoken to spoke highly of the staff in the home, one resident said, “The girls are very good here.” Another resident said, “It’s a big change from being in your own home but it’s the next best thing.” Residents are encouraged to take ownership of their own rooms and personalise their private space. Many residents expressed satisfaction about the environment and valued the flexibility in routines. Residents said they could go to their room whenever they wanted, and a group of four residents met up regularly to chat and socialise in the privacy of one of their bedrooms. The staff and manager appeared committed to providing good care to residents in the home. Comments from residents over the past two inspections have been consistently positive about the services and staff in the home. One resident said, “I have been here for 12 years, and if I didn’t like it I wouldn’t stay. I’m snug in my little room and I can go there whenever I want.” There was a very high standard of cleanliness throughout the home. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 House DS0000021531.V278753.R01.S.doc Version 5.1 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 House DS0000021531.V278753.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed on this occasion. The key standards were assessed during the previous inspection. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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, 9 and 10 Care plans identified individual care needs and enabled staff to provide appropriate care and support to residents in the home. Policies and procedures were in place to ensure the safe handling and administration of medication in the home. Residents were treated with respect and their right to privacy was upheld. EVIDENCE: A care plan was in place for each resident which included background information and the reason for admission into the home. The daily recordings in the care plan highlighted any changes in care needs and care plans were amended accordingly. Monthly reviews were recorded in the progress notes and cross-referenced to a dated record. Most residents in the home have low dependency levels, and as a result there had been very little changes made in care plans. It was evident from talking to residents in the home that they felt involved in all aspects of their care planning. This is a small home resembling a domestic
Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 10 home in character and the way it is run is informal to reflect the ‘homely’ atmosphere. As a result of this, any consultation with residents about their care needs is carried out regularly and in an informal manner. These consultations have not been formally recorded to evidence the involvement of the residents, however, the manager intends to develop the way in which reviews are recorded to demonstrate that residents are fully consulted on their perception of their care needs and on the way in which they want their care needs to be met. There was a medication policy in place which included guidance for staff to follow for managing the receipt and disposal of medication, homely remedies and procedures for residents wishing to self medicate. Medication was provided in a ‘Venalink’ monitored dosage system and on this inspection, staff administered medication appropriately. At the time of the inspection no resident was self-medicating. During this inspection visit, the staff were observed treating residents with respect. Nine of the residents were spoken to and all of them commented on the professional approach of the staff. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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 Daily routines in the home demonstrated that residents were encouraged to maintain control over their lives and social activities were sufficient to meet the expectations and preferences of residents in the home. EVIDENCE: Residents in the home said that daily routines in the home were flexible and that they had the opportunity to arrange their own routines. One resident said that she and three other residents met regularly in her room each morning for a chat and socialising and that this was something they really enjoyed. There was evidence in the reviews that residents were consulted about their interests, and every effort was made by staff to help residents to maintain contact with the local community. One resident has been attending a painting class held in the local community centre for a number of years, and still regularly attends this group. Residents confirmed that they had access to a range of activities, although one or two said that they preferred not to attend. One member of staff has special responsibility for organising activities in the home. The weekly activities were documented in a format that recorded the activities offered, a list of
Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 12 participants and of those residents choosing not to attend. Activities included outings, poem reading sessions, ‘ladies nights’ and bingo. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed on this occasion. The key standards were assessed during the previous inspection. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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): 20 and 26 The home was clean, tidy and comfortable, providing an accessible, safe and comfortable environment for residents living in the home. EVIDENCE: The home was clean, well maintained, accessible and suitable for residents with low dependency levels. Some areas of the home needed re-decoration in order to maintain standards in the home, and the manager was aware that a programme of maintenance and decoration must be maintained. The grounds surrounding the property were tidy and well maintained and access to the garden area was via a ramp. The home is an adapted house and would not easily meet the needs of residents with physical disabilities and this was reflected in the home’s admission policy. The home comprised of 2 spacious lounges and a dining room. Furnishings in the home were domestic in character and appeared to be of good quality. Residents said they were free to come and go as they pleased and were observed to access all parts of the building. A visiting professional said she always found the home to be clean and tidy.
Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 15 Three bathrooms and six toilets were located throughout the building providing easy access for residents. Adaptations including grab rails were fitted to promote independence. One of the bathrooms was fitted with an assisted bath and a hoist was provided in the remaining two bathrooms. Residents had access to communal facilities and to their bedrooms via the use of a passenger lift. Most bedroom doors were fitted with locks which were capable of being overridden in the event of an emergency, and enable residents to be offered the opportunity to have a key to their own bedroom promoting privacy and independence. The remaining locks were scheduled to be fitted over the next three months. Water outlets had been fitted with individual thermostatic mixing valves to ensure that water temperatures were regulated as close as possible to 43 degrees centigrade to avoid residents suffering from burns and scalds at high water temperatures. Systems were in place to record regular checks of water temperatures throughout the home. Risk assessments had been completed to ensure all parts of the home were safe. Residents spoken to expressed satisfaction about their rooms, and felt they had been given the freedom and opportunity to personalise their own private space. There was evidence that residents felt an ownership of their rooms, which had been personalised to reflect individual tastes. There were two cats and two dogs in the home, which were appropriately supervised by staff during busy periods when residents were moving about. Residents expressed affection for the pets in the home. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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): 29 and 30 Residents were protected by the recruitment and training practices operated by the home. Training programmes were insufficient to ensure the staff team were developing skills and gaining knowledge of good care practice. The home must ensure that staff are given opportunities for training and development EVIDENCE: Since the last inspection all staff files had been audited to ensure they contained the necessary information on file. Criminal Record Bureau Checks (CRB) had been obtained for all staff working in the home and these were examined at the time of inspection. Files examined contained two written references. Records of staff training was contained in photographic frames and displayed around the home. Discussion took place, about maintaining a record of all the staff training on each individual staff file for easy reference purposes and to monitor the training and development needs of staff. Since the last inspection there had been a turnover of staff and several new staff had been recruited. As a result, a number of staff did not hold the NVQ qualifications. As a result of changes in the staff team structure, training had not been prioritised. The manager must ensure that all staff training needs are identified through the supervision process, and that arrangements and opportunities are provided for all staff to access NVQ training.
Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 17 Moving and handling training had been booked for all staff to attend in February 2006. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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): 33 and 38 The home provides a service that has the procedures and systems in place to promote the interests, safety and well being of residents in the home. EVIDENCE: The manager confirmed that all Health and Safety policies had been reviewed and updated and that risk assessments were regularly reviewed. The manager provided a completed checklist confirming health and safety records and maintenance check had been carried out on lifting equipment and fire equipment. Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 3 X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 X X X 3 X X X X 3 Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 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 Standard 30 Regulation 18 Requirement The registered manager must ensure that staff training needs are identified through the supervision process and that they are provided with training appropriate to the work they are to perform. The home must achieve a ratio of 50 trained staff to Level 2 NVQ. All staff must receive three paid training day per year. The manager must provide a training programme/schedule for all new staff employed by the home. Timescale for action 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashley House DS0000021531.V278753.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 House DS0000021531.V278753.R01.S.doc Version 5.1 Page 22 - 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!
