Inspection on 20/04/05 for Ashling Lodge

This inspection was carried out on 20th April 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

Ashling Lodge 04/09/07

Ashling Lodge 09/11/05

Ashling Lodge 04/01/05

Ashling Lodge 13/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ashling Lodge 20 STATION ROAD ORPINGTON KENT BR6 OSA Lead Inspector MONICA HANSCOMB UNANNOUNCED 20 April 2005 10:00 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. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service ASHLING LODGE Address 20 STATION ROAD, ORPINGTON, KENT, BR6 0SA 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) 01689-877946 CHISLEHURST CARE LIMITED CRH- CARE HOME Category(ies) of OP - OLD AGE - 13 PLACES BOTH MALE/FEMALE registration, with number of places Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 04/01/05 Brief Description of the Service: Ashling Lodge is a large detached two storey house converted to provide care and accommodation for elderly people. The home has a large coservatory built on the front a busy main road by a steep drive with some off street parking. Service user accommodation is on both floors accessed by a stair lift.There is wheelchair access to both the front door and the fire exit leading directly onto the rear garden. The home is within a short walking distance of orpington Town centre with its range of shops and leisure facilities and public transport links. Central heating is provided to all area of the home and the radiators are guarded to lesson the risk of an accident. There are hanrails in the corridor areas with grab rails provided in toilet and bathroom areas and specialised bathing equipment available. All toilet and bathrooms are lockable and can be accessed from the outside in emergency. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.5 hours and was carried out as part of the statutory inspection programme. The inspection included a tour of the premises, inspection of some records and safety systems, Three staff spoke to the inspector was able to observe staff inter action with eight residents present during the day. Some relatives were visiting and the inspector was able to see the interaction with the staff and listen to their comments. The inspector thanks all who participated with the inspection. What the service does well: What has improved since the last inspection? Storage space has been found for wheelchairs etc., leaving the bathrooms usable when required. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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 Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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) 1,2,5. There has been no progress in updating the Statement of Purpose, as the organisation has not sent a copy of the updated version to the Commission for Social Care. This has been required in the last two inspection reports. Without this there is no assurance the service users are given the information they need to make an informed choice about where to live. There was no evidence the service users are given a contract of the terms and conditions with the homes. EVIDENCE: The updated Statement of Purpose has not yet been sent to the Commission for Social Care Inspection as required at the last inspection. This may have been completed but the carer left in charge of the home did not have any knowledge about the new document but was able to provide the old copy. This requirement has been requested on two previous occasions and it is a requirement this document be sent to the commission within two months of the inspection. Service users are given a copy of their terms and conditions at the point of moving into the home. A copy of this document is held at the company’s head Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 9 office and the carer was not aware of the document, therefore there was no evidence this action had been taken. All prospective service users and their families and care managers are invited to meet the staff and current service users and to look at the accommodation before making a decision to live at the home. There is a period of six weeks before the placement is deemed permanent Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) ,9, 10. The responsible person must insure all medications are safely stored and checked, not left on the floor as they were found. However the currant medications were found to be correct and tally with the medication administration sheets. EVIDENCE: Service users medications were kept in a locked cabinet and were found to be all in date. Dosette boxes contained services users medications and the records seen showed all doses of the medication had been given and signed for to date. All staff who administer medication have attended the “ Safe Handling of Medication “ training. Staff signatures were seen in the front of the of the medication administration record folder. A new batch of filled dosette boxes were found on the floor of the kitchen/office, which due to the sudden departure of the registered manger had not been checked and locked away. The service users needing help with personal care are attended to in the privacy of their own rooms. All the bedroom doors had a lock, which could be opened from both sides in the case of emergency. Carers were seen to be knocking at the doors and awaiting a reply before entering the bedrooms. The Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 11 service users spoken with confirmed they were treated with respect and were pleased with the quality of care given. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 The social activities and meals are both well managed and provide daily variation and interest for people living in the home. EVIDENCE: The service uses spoken with, confirmed they were very happy with the lifestyle they experience at the home. They were realistic about the activities, which they could undertake, as one resident stated you don’t expect to play football at our age! Other residents said they were very happy and enjoyed a good chat. When asked what activities they did they stated gentle exercise, musical movement and singing. During the inspection visitors of the residents were arriving and being greeted by staff in a pleasant manner and offered a hot drink. The residents have an open invitation to attend coffee mornings at the local Baptist Church with assistance, if required. The residents were very happy with the meals they received. They stated they always had a choice of food for each meal during the day. They especially appreciated the food was home cooked and they liked the homemade cakes and fresh fruit. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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) 16,18 The home has a detailed complaints policy and procedure, which, states all complaints will be thoroughly investigated within timescales stated and compliance. EVIDENCE: There has only been one complaint since the last inspection, which has not yet been fully investigated. The home has a complaints policy, which gives timescales for informing complainants about the investigations and the outcome. All residents are given a copy of the complaints procedure, which informs them how to make a complaint. Residents stated if they needed to make a complaint they would make it to management There is a complaints notice displayed in the entrance hall. Training about adult protection has been given to all staff by the social services department of the London Borough of Bromley. Eight members of staff have undertaken Adult Protection as part of their NVQ courses. Newly appointed staff have a CRB check before they are allowed to start work. The home has a procedure for whistle blowing, which complies with the Public Disclosure Act 1998 and the Department of Health’s guidance ‘No Secrets’ Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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) 19,20,22,23,24,26, The home continues to carryout maintenance of the property, as and when the need arises, which provides a safe environment for residents. A lifting hoist for manual handling of residents was not seen during the inspection. The provision of a hoist, considering the dependency of some of the residents, must be considered urgently for the protection of both residents and staff. The home was clean and tidy and the residents were chatting to each other and having a good laugh. EVIDENCE: The home was clean and tidy and there was some maintenance tasks being carried out during the inspection. The home has ramped access for wheelchairs and all residents’ bedroom doors had a lock, which can be opened from both sides in an emergency. The lounge and conservatory where residents were sitting were comfortable warm and homely. The dining room was ready for the residents to use at dinner- time. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 15 The ground floor bathroom had been cleared of wheelchairs and other items and at the time of inspection the bathroom could be used for bathing immediately. The shower hose was not re- inspected, (standard 22 in the last inspection report) as some one was using the toilet in the first floor bathroom. This will be checked at the next inspection. The home provides a hoist to help residents in and out of the bath and there are raised seats on all toilets, which help residents maintain their independence. The organisation has still to provide a mobile hoist for manual handling needs. The residents’ own bedrooms were clean and tidy and personalised with pieces of furniture and photographs of family and friends. The double bedroom had a screen providing privacy for both residents. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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) 27,29,30 Although the home was understaffed at the time of the inspection due to the registered manger leaving the previous day the staff were carrying out their duties very well. The residents were happy and well looked after but the care staff were unable to take a break. The recruitment procedures were robust and provided all the safeguards to offer protection to the people living at the home. The number of staff on duty at the time of the inspection was not sufficient to allow them to take any breaks. EVIDENCE: The home was understaffed at the time of the inspection and the member of staff in charge of the home had only been working there for four weeks having been transferred from another home belonging to the organisation, but knew all about the residents and their needs. The residents were laughing with her and the other carer creating a happy atmosphere. However, without the manager, who had left the previous day, the home was understaffed given the dependency of some of the residents. One of the directors was at the home earlier in the morning but had “popped out” and did not return during the inspection but could be contacted in case of an emergency. The carers were coping well but were unable to take a break. Both members of staff are to be congratulated for carrying out their duties so well. Both staff had received training and knew exactly what they had to do. One member of staff had obtained her NVQ3 qualification and the other member of staff was a trained nurse who was waiting to attend a course, which would allow her to nurse in this country. The home has a robust policy and procedure for the recruitment and selection of staff. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 17 Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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 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) 31,33,37 Although the home does not have a registered manger in place the home was running effectively and the welfare of the residents was not an issue. The two staff on duty were managing very well. EVIDENCE: There was no registered manager at the time of the inspection as she had left the day before. The Director of Nursing had visited the home earlier in the morning but was not there during the whole of the inspection. She was contactable in an emergency. The residents were all chatting and laughing in the lounge and it was noticeable the rapport between the residents and staff was very good. The home was clean and tidy at the time of the inspection. The home has a full set of policies and procedures, which promote and protect the residents. All records seen up to date and in good order and were kept secure in locked cupboards. Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x 2 3 3 x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 x 3 x x x 3 x Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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. 2. Standard 1 2 Regulation 4 5 Requirement An updated Statement of Purpose must be sent to the Commission The organisation must produce a Service Users Guide which contains all the information in Regulation5 of the Care Homes Regulation The registered person must make arrangementsthe safe keeping of medication delivered to the home The registered person must make suitable arrangements to provide a safe system for moving and handling service users The registered person must ensure the number of staff working in the home which are appropriate to the needs of the service users The registered person shall appoint a person to manage the home Timescale for action 20/06/05 20/06/05 3. 9 13 20/06/05 4. 22 5 20/06/05 5. 27 18 20/06/05 6. 31 8 July 05 Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 21 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 Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 Page 22 Commission for Social Care Inspection SIDCUP AREA OFFICE RIVER HOUSE 1 MAIDSTONE ROAD, SIDCUP 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 Ashling Lodge G51 S6918 Ashling Lodge V221537 15-04-05 STAGE 4 doc.doc Version 1.20 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. 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