This inspection was carried out on 3rd November 2008.
CSCI found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Ashley Manor Nursing Home 17 - 19 Cambridge Road Waterloo Liverpool Merseyside L22 1RR The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Simon Hill Date: 0 3 1 1 2 0 0 8 Information about the care home
Name of care home: Address: Ashley Manor Nursing Home 17 - 19 Cambridge Road Waterloo Liverpool Merseyside L22 1RR 01519282249 01519200094 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: A.C.G. Management Limited care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 0 0 Over 65 45 30 Conditions of registration: The registered person may provide the following categories of service only. Care home with Nursing - code N, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category - Code OP, (maximum number of places: 30) Dementia over 65 years of age - Code DE (E) (maximum number of places: 45) The maximum number of people who can be accommodated is: 75 Date of last inspection Brief description of the care home Ashley Manor is a large care home situated in Waterloo. The home overlooks a public park and there is access to local transport. Ashley Manor provides accommodation for up to 75 older people and is divided in to 3 categories of care. This includes 30 places for residents with general nursing care needs, 33 places for residents who have Care Homes for Older People Page 2 of 8 dementia and nursing care needs and 12 places for people who have dementia and require personal support. The home is divided into 3 separate areas thus enabling residents to have their own recreational areas and bathroom facilities. There are 55 single and 10 double bedrooms, some of which are ensuite. The home is equipped with a call system with an alarm for the residents and the home has manual handling equipment to assist those who are less independent. There is car parking space to the front and patio areas and gardens. Ramp access is available. CCTV cameras operate in main entrance areas for security purposes only. The fee rate for accommodation is from £389.50 to £550.00 per week. Care Homes for Older People Page 3 of 8 What we found:
We visited the home because the manager had told us about a mistake that had happened with a controlled drug (a medicine that can be misused). The visit was carried out by a pharmacist inspector. It lasted five hours and involved speaking with the manager, the deputy manager, two nursing staff and two care staff. We observed part of the morning medicines round and checked the medicines stocks and records of a sample of people who live in the home. We gave detailed feedback to the managers at the end of the visit. Overall we found shortfalls in medicines handling that need to be addressed to make sure medicines are handled safely. When we checked the records of medicines given to people for the last three weeks we found they were usually signed and up to date. However, we found seven peoples medicines records were not signed for the previous day, in total 31 doses. The deputy manager said that if gaps were found on the records staff were signing them when they were next on duty. This is not good practice as it is not a true record because staff would not always be able to confirm whether they have given the medicine. Failing to sign records when giving medicines can lead to mistakes that could seriously affect peoples health and wellbeing. We looked at a sample of care plans and records to find information about how when required medicines were to be given. One person that was having regular seizures had no care plan about how they were to be managed. On the day of the visit this person had a seizure and was given one of their medicines unnecessarily, this was confirmed by the deputy manager. This person also had swallowing difficulties and there was not enough information in the care plan about how to safely manage this. Another person was prescribed several pain relief medicines on a when required basis but there was no care plan about how to assess and manage their pain. Another person was prescribed a medicine for agitation but there was no care plan about how to manage their aggression and how to use their prescribed medicine. Having clear written plans helps make sure people get their medicines when they need them. We looked at the times medicines were given and we found most of the records stated the correct time. However, on the day of our visit we found several medicines were not given at the correct time in relation to food intake. We saw at least three medicines that were given with food instead of before. Giving medicines at the wrong time can seriously affect a persons health and wellbeing. We checked how controlled drugs (medicines that can be misused) were handled. A suitable secure cupboard was used for storage and a special register was used for record keeping. We looked at how the managers had dealt with a recent mistake that involved a missing pain relief patch, this had been thoroughly investigated and appropriate action had been taken to help prevent it happening again. Staff had been retrained on how to handle controlled drugs and daily checks of the stock and records were being carried out. Having good arrangements for the handling of controlled drugs helps prevent them being misused. We looked at how medicines were checked and audited. We saw evidence of weekly and monthly checks and these had found some mistakes that had been acted upon to Care Homes for Older People Page 4 of 8 help prevent them happening again. However, our checks found further mistakes and on the day of the visit we found the wrong dose of a liquid medicine was given because staff had not calculated the dose correctly. Another liquid medicines stock did not add up, showing either the wrong dose had been given or the dose had been missed on several occasions. Regular, efficient checks of the medicines are important because they help to make sure they are being handled safely. The manager said that formal competency checks on care staff were carried out when they first started handling medicines but this was not reviewed on a regular basis. Some medicines handling training had recently been provided to all staff and the manager said further courses were planned. Nursing staff had not had their competency formally assessed but the manager said that they were also planning to do this. Competency checks on staff help make sure they have the necessary skills to handle medicines safely. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 30 18 (1) (c) (i) Staff must be qualified, competent and experienced to care for the residents. Staff must receive a structured induction to ensure they have the skills and knowledge to provide the care and support to the residents 17/09/2007 2 37 17 (1) Resident records must be (b)Schedule 3 kept secure in the care home. Care summaries of residents care and social needs must be kept secure. 17/08/2007 Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Medicines must be given to people correctly. Receiving medicines at the wrong dose, wrong time or not at all can seriously affect a persons health and wellbeing. 05/12/2008 2 9 18 There should be an effective system in place to check staff competence. This will help make sure they have the skills to handle medicines safely. 05/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 9 When necessary, information on how medicines should be used should form part of an individuals care plan to make sure they are given to people correctly. Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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!
