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Inspection on 30/01/06 for Ashlyns Residential Home

Also see our care home review for Ashlyns Residential Home for more information

This inspection was carried out on 30th January 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The administration and management of the home is well maintained. All the service users appeared well cared for. One service user recently had her 100th birthday celebration. Birthday banners and cards were displayed in her bedroom. She appeared happy and content.

What has improved since the last inspection?

New guidelines and a falls management procedure have been made available to staff. The training of staff in falls management has taken place. The home has made arrangements with a new pharmacist for the supply of medicines. Medicines and drug trolleys are now stored in the newly constructed storage room. The front lounge has been renovated into a double bedroom which is occupied by a married couple. The sun lounge and the adjacent room have been transformed into an activity and recreation room.

What the care home could do better:

Currently all written care plans are reviewed annually with the service users and their next of kin, who then sign them. The care plan will have an additional section for the service user and/or their next of kin to sign when care need changes in the interim.

CARE HOMES FOR OLDER PEOPLE Ashlyns Residential Home Chesham Road Berkhamsted Hertfordshire HP4 2ST Lead Inspector Yoke-Lan Jackson Unannounced Inspection 30th 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 Ashlyns Residential Home DS0000019271.V281114.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. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashlyns Residential Home Address Chesham Road Berkhamsted Hertfordshire HP4 2ST 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) 01442 870565 01442 861601 Colley Care Limited (Trading as B & M Care) Mrs Diane Delicate Care Home 58 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (39) of places Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2005 Brief Description of the Service: Ashlyns, provided by B & M Care, is a purpose built residential care home for 58 service users in the older people category. The home has a Dementia Unit (for 19 service users) and a Residential Unit (for 39 service users). The building, part of a large country estate, is situated on the outskirts of Berkhamsted, close to the A41. There are ample parking spaces nearby. The home has a front driveway and the main entrance to the building is security locked. Both units have ample communal spaces. All the bedrooms have ensuite facilities. Some bedrooms are double bedrooms. They are accessible to wheelchair users. The Dementia Unit has 19 bedrooms, two lounges, a small nurses station, a kitchenette and a dining room. Overlooking the lounge is the sensory garden. The interior décor and furnishing are designed to provide a homely and comfortable atmosphere. Security locks are in place at both ends of the Dementia Unit for the safety of the service users. The corridor extends into the Residential Unit, with 39 bedrooms, a lounge, a laundry room, a main kitchen and two dining rooms. The building is generally well maintained, both externally and internally. In the centre of the building is the courtyard that is well designed with an ornamental fountain, attractive potted and climbing plants and comfortable garden furniture. There is a large sun lounge, adjacent to an activity room and overlooking the back garden, which is well kept and accessible to wheelchairs. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The registered manager and the deputy manager were both present. There were 55 service users and 3 vacant bedrooms. Both the Dementia and Residential Units were inspected. Care plans, medication records and other documents were examined. Some service users were seen walking about, others were waiting in the lounge for the day’s activity to commence. All the service users appeared well cared for. (Please see below for details of the inspection findings). What the service does well: What has improved since the last inspection? New guidelines and a falls management procedure have been made available to staff. The training of staff in falls management has taken place. The home has made arrangements with a new pharmacist for the supply of medicines. Medicines and drug trolleys are now stored in the newly constructed storage room. The front lounge has been renovated into a double bedroom which is occupied by a married couple. The sun lounge and the adjacent room have been transformed into an activity and recreation room. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 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. Ashlyns Residential Home DS0000019271.V281114.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 Ashlyns Residential Home DS0000019271.V281114.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): 1, 2, 3, 4, 5. Prospective service users have the information they need to make an informed choice. A trial period is arranged following a full assessment. EVIDENCE: The Statement of Purpose is reviewed and updated. A Service User Guide is given to each service user. A copy of the terms of contract is kept in their personal file and one is given to the prospective service user on admission into the home. Ashlyns Residential Home DS0000019271.V281114.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, 8, 9, 10. Each service user has a written care plan that is kept up to date. Service users are treated with respect and their privacy is upheld. The administration of medication is in accordance with legislation. EVIDENCE: On the day of the inspection, one service user had her care needs reviewed as a result of restricted mobility. The General Practitioner was involved. Following discussion with the inspector, the management has agreed to include a section in the care plan for the service user and/or their next of kin to sign following a change in care needs in the interim. Currently all written care plans are reviewed annually with the service users and their next of kin, who then sign them. The home has made arrangements with a new pharmacist to supply all the medicines. All medication records were examined and they were accurately completed. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 10 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, 13, 14, 15. Service users maintain contact with their family and friends. They are helped to exercise control over their lives and are encouraged to participate in activities. The meals provided are wholesome and balanced and choices are given. EVIDENCE: The activity and recreation room is equipped with books and materials for art and craft. The activity programme varies and is planned following consultation with service users. Their preferences are taken into consideration. On the day of the inspection, the service users in the Residential Unit were being entertained in the afternoon by a group of children from the local school. In the Dementia Unit, all the service users participated in the afternoon activity of the day. Tea was served afterwards. The meals provided are varied and wholesome. The menu is reviewed regularly and choices are given. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 11 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): 16, 17, 18. The home has a robust Complaints’ Policy and Procedure which are readily available to the service users and their relatives. EVIDENCE: The home has received one complaint, which was investigated within the time specified in the policy. The home follows the Adult Protection Procedure of Hertfordshire Social Services. Staff has knowledge of the Whistle Blowing Policy. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 12 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): 19, 20, 21, 22, 23, 24, 25, 26. Service users live in a safe, comfortable and homely environment. The premises are well maintained. The facilities provided are adequate. EVIDENCE: On the day of the inspection, the external grounds and the internal environment appeared neat, clean and well maintained. Some rooms within the premises have been rearranged and redecorated. The front lounge is now used as a double bedroom for a married couple. The new recreation and activity room is adjacent to the sun lounge and is now in full use. All medication are now stored in one storage room in the Residential Unit. All facilities and equipment examined have been serviced with dates noted. They are regularly maintained. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 13 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): 27, 29, 30. The staffing level has been maintained and is adequate. Staff are regularly supervised. Service users are supported and protected by the home’s recruitment and selection policies and procedures of the home. EVIDENCE: On the day of the inspection, the home was adequately staffed. The staff demonstrated their skills and knowledge in caring for the service users who appeared well looked after. There are a range of policies and procedures to provide guidance to staff, including the guidelines and procedure on the management of falls. The staff have appropriate training to ensure that they are able to meet the needs of the service users in their care. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 14 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): 31, 32, 33, 36, 37, 38. The administration and management of the home is maintained. All the maintenance and servicing records are updated and they comply with legislation. The health, safety and welfare of the service users are promoted and protected. EVIDENCE: The standard of administration and management of the home is maintained. All facilities are serviced and all records for the protection of the service users are kept up to date and handled in accordance with the Data Protection Act 1998. Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 15 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 16 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. Standard Regulation Requirement Timescale for action 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 Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Ashlyns Residential Home DS0000019271.V281114.R01.S.doc Version 5.1 Page 18 - 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!