Inspection on 09/06/05 for Ashley House Nursing Home

This inspection was carried out on 9th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashley House Nursing Home 28/11/06

Ashley House Nursing Home 26/01/06

Ashley House Nursing Home 14/01/05

Ashley House Nursing Home 15/07/04

Ashley House Nursing Home 09/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashley Nursing Home 118 Trafalgar Road Cirencester Gloucestershire GL7 2EN Lead Inspector Janice Patrick Announced 9 June 2005 10:15am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashley House NUrsing Home Address 118 Trafalgar Road Cirencester Gloucestershire GL7 2EN 01285 650671 01285 650672 aldena@bupa.com BUPA Care Homes (BNH) Ltd NO.2079932 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Ann Lilian Alden Care Home OP Old Age (47) Category(ies) of OP Old Age (47) registration, with number of places Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Temporary variation to client categories DE(E) for 1 (one) named service user. Date of last inspection 14 January 2005 Brief Description of the Service: Ashley House is situated on the outskirts of Cirencester Town and is within walking distance of a main bus route. This Care Home is well known within the local community and offers nursing care to the older person. The Home is predominantly private fee paying, but will consider Social Service or Health funded care on an indivdual basis. Private accomodation is provided in single bedrooms with ensuite facilities, some larger bedrooms are available for those who wish to share. A few bedrooms overlook the courtyard garden and have their own patio area. Spacious communal rooms also have a view of the courtyard where the flowers and water feature can be enjoyed in the summer months. The Home is staffed with qualified nurses, 24 hours of the day. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out between the hours of 10:15am and 4pm by one inspector. The Registered Manager was on holiday, therefore the Deputy Manager assisted with the inspection. Several residents were spoken with, including staff and a visitor. Various records and care documentation was seen and a tour of the building was carried out. Requirements from the previous inspection report were discussed and checked for compliance. The residents appeared relaxed and the Home was running smoothly. What the service does well: What has improved since the last inspection? Staffing has stabilised with staff turn over reduced. The written content and how care plans are being reviewed has changed and improved. Residents seemed more confident that staff were aware of their specific care needs. The main reception area has been totally redesigned offering more open space and making the receptionist’s desk a more focal point for both residents and visitors. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 A thorough assessment process prior to admission ensures that residents’ needs are identified prior to admission and enables the Manager and resident to decide whether it is an appropriate Home for them. EVIDENCE: Two completed pre-assessment forms, which had been carried out prior to the admission of the residents, were seen. The form’s format has been discussed in past inspections and now thoroughly meets this standard. A requirement from the previous inspection report was followed up. This was to ensure that during the delivery of care the resident’s wishes and preferences are taken into account. These are usually identified during the assessment period and highlighted within the residents care plan, but staff were not always following the care plans (see page 10). Staff turn over has slowed down, meaning that staff are getting to know residents over a longer period of time and their specific likes and dislikes. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 standard(s) 7, 8 & 10 A more inclusive and consistent approach to care planning is helping staff to be more aware of residents’ assessed health needs and their preferences, however specific care plans are still not always being followed, leaving care needs unmet. The care is delivered in a manner that preserves the residents privacy and upholds their dignity. EVIDENCE: A requirement from the last inspection report was followed up. This was to ensure that the care needs of residents were reflected in their plan of care and that the plan was being followed. The Inspector could see that a lot of work has been done to improve both the written text and how staff relate to and reference the care documentation. A new system had been introduced, which guides staff through a planned review process. The written content is now audited comprehensively and care staff now have to refer to the actual care plan when writing their daily report. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 10 These are kept in the resident’s bedroom to allow freedom of access, but also to encourage the paperwork to become a working tool that is referred to on a daily basis. Two sets of care plans showed that a lot of involvement had been sought, one by the resident themselves and by a husband. Unfortunately one resident was not having a specific care need met, although this was clearly documented in the care plan. The care documentation demonstrates that residents are receiving many different types of health care intervention, including the skills of external health care professionals and NHS experts. One lady was awaiting a visit by the Ulcer Specialist who was due to visit on the day of this inspection. Another example was of the Community Mental Health team offering a lot of support and input, although the resident’s representative had consistently declined this. One resident spoke of how care was given in relation to her privacy and the respect afforded to her. She said she could not fault the staff in this area. The Inspector observed this for herself as she walked around the Home. Another resident described some of the intimate care they needed and in doing so, spoke highly the staff confirming that they were always aware of his feelings and initial embarrassment. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 Links with the local community, family and friends are strong and help enrich the residents’ social opportunities. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The Home has longstanding links with the local community and those that are able enjoy visiting Cirencester town. The Local Park and Abbey ruins are popular when the weather is mild. One resident had been for a pub lunch with an old friend and had thoroughly enjoyed the outing. Another was shopping in Cirencester at the time of the inspection. Friends and relatives were seen visiting throughout the day. One relative explained that she was free to visit when she liked and that staff were always very hospitable. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 12 A group of residents were playing a general knowledge game in the lounge and were clearly having fun. The group comprised of varying capabilities and was led by the popular activities co-ordinator. One to one activity and interaction is also provided. An activities newsletter is circulated with forthcoming events. Some residents chose not to join in, preferring the quietness and sun in the courtyard garden. The Inspector visited the dining room during the first lunch sitting which caters for residents who, either require feeding or require a high degree of supervision to maintain an adequate dietary input. All food was presented well and included an extensive sweet trolley. Some residents prefer to take meals in their bedrooms and it was in the case of a resident who was in bed where the specific care needs were not being met. This was referred to the Deputy Manager, who took this omission very seriously. Again these needs were clearly stated in the care plan within the bedroom. Options for external advocacy are advertised on the main notice board. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 standard(s) 18 The staffs’ level of knowledge pertaining to Adult Protection and aggression has increased, offering the residents a higher level of protection against abuse. EVIDENCE: Nine staff, a mixture of day and night staff, recently attended a training session on violence and aggression in the workplace. This included how to deal with these incidents and avoiding potential abusive situations. The Inspector spoke with a senior carer who demonstrated a good understanding of both Adult Protection issues and of the Whistle blowing Procedures. A new carer was also aware of these subjects within her induction pack, but had yet to cover the subject. She was however, able to explain the correct action to take if she was concerned about any potential abusive situation. All residents spoken with said they felt safe and well treated. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 standard(s) 19, 20 & 26 A clean and well maintained Home offers comfortable accommodation and grounds for residents to live in and enjoy. EVIDENCE: The Inspector toured the Home both inside and outside and found both to be well maintained. The maintenance person was spoken with and the rolling programme of decoration and repair discussed. The communal areas are spacious, particularly now the reception area has been redesigned. This is now open plan, but not liked by all the residents who say they have lost some of the smaller, quieter areas to sit. The advantages are that all have easier access to the receptionist and interaction between receptionist and resident has clearly increased. Residents did say that they were enjoying sitting within the new area overlooking the courtyard garden. The Home was clean and systems are in place to reduce infection. Good practice was seen with the use of alcohol based hand gels, strategically placed for staff use. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 15 Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 30 A more consistent workforce that is well trained is enabling the Home to improve the standard of care provided to the residents. EVIDENCE: On the day of this inspection the Home was well staffed in number. The skill mix was also well balanced and new staff were being inducted appropriately. The Inspector spoke with one such carer who described her induction period so far. She was being mentored by a more experienced carer and following a set plan of learning. All new staff are prepared for NVQ training in care and existing staff are updated in relevant training accordingly. The recording of some mandatory training was not in place, however, the Deputy Manager could confirm that this had taken place as she had provided the training on this occasion. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 37 The Manager and her senior staff have a clear and consistent view of how the home should run and the standard of care that should be expected. This is effectively communicated and audited, so as to improve all aspects of the residents’ life. Through effective policies and procedures and recent improvements in record and care documentation keeping, residents are protected and their rights are upheld. EVIDENCE: The Manager continues to deploy effective communication through meetings held on a regular basis with all levels of staff. Minutes of the last senior staff meeting held in May were seen. The agenda was broad and included clear guidance on several subjects. The care staff confirmed that regular staff meetings occur including additional informal gatherings where things can be discussed or questions asked. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 18 Regular resident meetings are held with a main representative who will take forward any issues to be raised. Residents and a visitor agreed that the Manager and Deputy Manager are always available to talk with. All documentation is held appropriately. Access to care plans is encouraged by keeping them within the residents’ bedrooms. The Home complies with Data Protection guidelines. CCTV is in place but this does not compromise the residents’ privacy in any way. Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x 3 x x x x 3 x Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15(1) Requirement Timescale for action 7th August 2005 2. 30 17 Schedule 4 (6)(f) The written care plan that instructs staff on how care needs are to be met, must be followed by those delivering the care. (Previous timescale not met). A record of all staff training must 7th August be kept and updated accordingly. 2005 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 Good Practice Recommendations Ashley Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Nursing Home D51_D03_s16370_Ashley House_V225924_090605_stage 4.doc Version 1.30 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. 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