Inspection on 16/05/05 for Ashlodge

This inspection was carried out on 16th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Ashlodge 23/08/07

Ashlodge 22/08/06

Ashlodge 24/11/05

Ashlodge 27/11/04

Ashlodge 25/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ashlodge 83 Cantelupe Road Bexhill on Sea East Sussex TN40 1PP Lead Inspector Niki Palmer Unannounced 16 May 2005 10:30 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. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashlodge Address 83 Cantelupe Road Bexhill on Sea East Sussex TN40 1PP 01424 217070 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) Mr Balasingam Vijaykumar Mrs Kuhayini Vijayakumar Mrs Kuhayayini Vijaykumar Care Home (CRH) 16 Category(ies) of Old age, not falling within any other category registration, with number (OP) 16 of places Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only older people will be accommodated. 2. That residents accommodated must be aged sixty five (65) years or older on admission. 3. That the maximum number of residents to be accommoated will not exceed sixteen (16). 4. That the home accommodates one named adult over the age of sixty five (65) years with dementia, whose needs can be accommodated by the home. Date of last inspection 27 November 2004 Brief Description of the Service: Ashlodge is a detached property situated a short distance from Bexhill seafront, and a short walk from the town centre with its shops and access to bus and rail routes. Accommodation is provided on two floors with a passenger lift to provide access to first floor accommodation. All bedrooms are of single occupancy with ensuite facilities. Eleven bedrooms are on the first floor, whilst five are on the ground floor. There are three spacious communal lounges, a dining area and access to a well kept rear garden. The home is registered to accommodate 16 older people. The registered providers are Mr and Mrs Vijayakumar who have owned the home since May 2003. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Ashlodge will be referred to as ‘residents’. This unannounced inspection took place on a Monday between 10.30am and 4.30pm. The inspection began with discussions with the acting manager of the care home in respect of progress made since the last inspection, followed by the examination of six care records. In order to gather evidence on how the home is performing, individual discussions took place with six residents, whilst others commented on their care during lunchtime, the inspector having been invited to join them for a meal. In addition, four carers and two visiting relatives were spoken with during the visit. Sixteen residents were accommodated at the time of the inspection. A detailed inspection of the premises and its facilities took place. What the service does well: Ashlodge offers residents a good level of personal care, provided by care staff who appear committed and caring. All residents and visitors spoke very highly of the care and facilities provided and used words such as ‘kind’, ‘well run’ and ‘a nice place to live’. A range of activities such as gentle movement and regular trips out are available to all residents to meet their individual preferences and needs. Residents were happy to show the inspector their private rooms, each of which were found to be furnished and decorated to reflect individual preferences. The overall standard of furnishings and décor is good, which contributes towards making this a homely environment. The home has a good complaints procedure in place, which ensures that any concerns, no matter how minor are addressed immediately. Visitors are welcomed at anytime of the day, and kept informed of their relatives well being. Ashlodge has an atmosphere that is homely, relaxed and caring. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 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. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 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 Ashlodge H59-H10 S41416 Ashlodge V227198 160505 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) 1, 3 and 6. Limited progress has been made by the home to update the information provided to new and existing residents, thus limiting the basis on which to make an informed choice. The fact that residents who are admitted on a short-term basis only do not have a pre-admission assessment completed potentially places them at risk. EVIDENCE: Two residents and one visitor to the home said that they had all seen a copy of the service user guide before they or their relative had made a decision to move in to the home. Although it gives a brief overview of the services provided, it is required to be updated to include the home’s statement of purpose, the terms and conditions of contract, details of the last inspection report and a copy of the home’s complaints procedure. Three of the residents and one relative spoken with at the time of the inspection confirmed that the acting manager had visited them at home prior to admission to carry out a full assessment of their needs. On the day of the inspection, in the case of the two most recent admissions the home care files did not contain any proof of a pre-admission assessment. The acting manager Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 9 stated that as both residents had been admitted for short-term respite, she did not consider it necessary to complete a pre-assessment. It is required that all new residents are assessed prior to admission to ensure that the home can meet their assessed needs. Intermediate care is not provided. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 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) 7 and 10. There is an adequate care planning system in place, which involves residents and their relatives, providing staff with the information they need to meet residents’ needs. However, individuals’ privacy and dignity is not maintained at all times and it is required that this be addressed in a revised code of practice for all staff to follow. EVIDENCE: Two of the residents spoken with stated that the acting manager had shared with them their plans of care the previous week and confirmed that she did this on a regular basis. It was pleasing to note that since the last inspection all six of the care plans seen contained a photograph of the individual, a pressure area care risk assessment and guidance for staff regarding individual mental health needs. One of the relatives spoken with said that he is kept informed of his relative’s needs over the phone on a regular basis as he lives a long distance from the home. He was very complimentary of the care his relative receives at Ashlodge. All of the residents have their own bedroom and a key to their door. Private telephone lines are also available on request. Although several of the residents commented on the care they receive as being ‘kind’, ‘helpful’ and Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 11 ‘respectful’, it was concerning to note that on two separate occasions two of the residents’ privacy and dignity were compromised. For example, during the sociable lunchtime period one lady was continually asked if she would like to use the toilet. In addition, the registered provider entered another resident’s bedroom without knocking, to show how the fire door was now closing/slamming shut (whilst the resident was trying to rest on her bed). These concerns were addressed with acting manager immediately. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 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 and 13. Activities are managed well within this home ensuring that choice and variation are available. Links with the local community are good, however unlimited access to the building potentially places residents at risk. EVIDENCE: The residents spoken with during the inspection said that although the home is generally quite quiet and peaceful, there is a range of activities both within and outside of the home. More independent residents take themselves out for a walk into the town or to the sea front, whilst others are supported on a one-toone basis by the care staff to go out for lunch or just for a walk. One-to-one support generally takes place during the week due to increased staffing levels. The acting manager has recently introduced ‘gentle movement’ three to four times a week, which comprises of listening to music whilst exercising. Four of the residents confirmed that this has proved to be quite popular. In one of the lounges there is an organ that was being played by one of the residents on the day of inspection. Two of the relatives stated that they are always made to feel welcome by the home at anytime of day. It was quite concerning to note that on arrival to the home care staff did not respond to the doorbell. At the same time, a GP arrived who let himself (and the inspector) in, before attracting the attention of staff. Access to the building is required to be reviewed for the safety of Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 13 residents. This is to be carried out in consultation with residents and visitors to the home. Although the standard of food and menus were not inspected on this occasion the lunchtime vegetarian option was tried with a selection of home cooked vegetables. It was found to be nutritious, hot and tasty. All of the residents spoke highly of the food provided, however several did complain of the portions being too large for their appetite. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 14 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. The home has a satisfactory complaints system in place, which was evidenced that residents’ views are listened to and acted upon. EVIDENCE: The home has a detailed complaints procedure in place, which is on display in the entrance hall. Two of the residents spoken with said that they feel confident that they could make a complaint and be listened to, but neither could imagine having to complain about any of the aspects of the running of the home as they felt that the home is very well run. Three minor complaints have been made by residents since January 2005. These are clearly documented and have been responded to appropriately. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 15 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, 23, 24, 25 and 26. The standard of the environment within this home is good, providing residents with an attractive and homely place to live. EVIDENCE: One of the registered providers is responsible for the maintenance of the care home, including carrying out and recording all health and safety and fire checks. The home is well maintained and decorated to a high standard throughout. All of the bedrooms are of single occupancy with en-suite facilities. All of those seen and residents spoken with during the inspection stated that they found the home to be warm, comfortable and homely. The vast majority of residents have their own furniture and personal belongings around them. It was a requirement from the previous inspection that a rolling programme of fitting guards to radiators is planned and completed. Risk assessments have been completed by the registered providers and were seen on the day of the Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 16 inspection. Hallways and bathrooms have been prioritised, but the work has yet to be completed. In response to another previous requirement made, advice was sought regarding the delivery of safe hot water temperatures to all bedrooms and bathrooms. All hot water temperatures are now checked and recorded on a weekly basis. There are three large communal lounges and a separate dining area, all of which were found to be clean, fresh and furnished to a high standard. There is a large garden to the rear of the property, which has recently been made more accessible to residents. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 17 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 and 30. Staffing arrangements and numbers are adequate to meet the needs of the residents accommodated. The arrangements for the induction of staff are good providing staff with a clear understanding of their roles. EVIDENCE: Thirteen care staff are employed, a cleaner and two part-time cooks. It was evident through speaking with staff and residents that staff turnover is low and that agency carers are rarely used. All staff spoken with stated that they enjoy working at Ashlodge and feel that the home is well run. There are two carers on each shift, and one waking night staff on duty. The rotas seen on the day of inspection and residents spoken with confirm that this home is adequately staffed. All of the residents and two of the visitors said that they found the staff to be kind and caring. All spoke highly of the acting manager. The acting manager is on duty Monday to Friday between 9am and 3pm. Of the 13 carers employed, only one is trained to NVQ level 2, and another to NVQ level 3. Three further members of staff are due to commence level 2 in September 2005. The acting manager is aware of the need to achieve at least 50 of care staff trained to level 2 by December 2005. All staff have recently undertaken first aid training, and all but two have received fire safety training. This was confirmed by the carers spoken to and was recorded in individual training files. Two newly appointed members of Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 18 staff said that they were given a thorough induction by the acting manager within their first six weeks of appointment. There was no evidence that foundation training had begun for new staff to N.T.O specification to provide them with further knowledge to meet the assessed needs of individuals. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 19 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 and 38. The home has been without a registered manager for some time, however is effectively run by the acting manager. There are no formal systems in place to receive residents’ feedback, which suggests that their views are not being fully taken in to consideration. EVIDENCE: The registered provider has been acting manager of the home since January 2004, when the previous manager left. She is aware of the need to submit an application to the CSCI to register a manager for the home. It is clear through speaking with residents, staff and visitors that she currently manages the home to a high standard. Although there is a ‘suggestion box’ for residents and visitors, there are no formal quality assurance systems in place in order to measure how the home is performing. The acting manager is aware of her responsibility to implement systems for residents’ and staff consultation. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 20 On the day of inspection a Fire Safety Officer carried out a routine inspection of the premises. He recommended to the registered provider that automatic fire door closures be considered throughout the home as door wedges are currently being used in some areas. Since the last inspection fire alarms are now being tested on a weekly basis and records kept, and all fire doors are now closing properly. In addition, all bedroom windows on the first floor have recently been fitted with restrictors to safeguard residents and risk assessments for the building have been completed and were seen on the day of inspection. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 21 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 2 1 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 2 x x x x 2 Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 22 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 OP1 Regulation 5(1)(a-f) 2 Requirement That the service user guide is updated to include the homes statement of purpose, terms and conditions of contract, details of the last inspection report and a copy of the home’s complaints procedure [THIS IS OUTSTANDING FROM THE LAST INSPECTION]. All new residents must be assessed prior to admission to ensure that the home can meet their needs. A revised code of practice is required to ensure that all residents are treated with respect and dignity at all times. Access to the building needs to be reviewed in consultation with residents and visitors to the home, whilst maintaining the security and safety of the building, its service users and staff. That all radiators assessed as posing a high risk to residents are guarded [THIS IS OUTSTANDING FROM THE LAST INSPECTION]. That an application to register a manager for the home is Timescale for action 30/08/05 2. OP3 14(1)(a) With immediate effect. 30/06/05. 3. OP10 12(4)(a) 4. OP13 13(4)(a) (b)(c) 30/08/05 5. OP25 13(4)(a) (c) 30/08/05 6. Ashlodge OP31 9(1) 7(1)(2)(a) 30/06/05 Page 23 H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 (b) 10(1)(2) 7. OP33 24(1)(a) (b) (2)(3) 8. OP38 23(4)(a) received within one month [THIS IS OUTSTANDING FROM THE LAST INSPECTION]. The home must implement a quality assurance sytem in order to measure the quality of care and services provided to residents. The results must be published and made available to all new and existing residents. That automatic fire door closures are fitted throughout the home in accordance with the recommendations made by the Fire Safety Officer. 30/08/05 30/11/05 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. 2. Refer to Standard OP28 OP30 Good Practice Recommendations That 50 of care staff are trained to NVQ level 2 by December 2005. That foundation training to the TOPSS / NTO specification is provided to new staff within their first six months of appointment. Ashlodge H59-H10 S41416 Ashlodge V227198 160505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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