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Inspection on 28/06/05 for Ashmore Nursing Home

Also see our care home review for Ashmore Nursing Home for more information

This inspection was carried out on 28th 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.

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 home currently provides the appropriate training and development for staff to enable them to care for the needs of all the residents. In addition to the training, the home accommodates for student nurses who are on placement from the college of nursing. The home are required to adhere to the requirements for placements as set down by the education department. The open atmosphere within the home ensures that staff, residents and their families are involved in the home. The Ashmore News magazine demonstrates that the home informs staff and relatives of the events within the home. A copy is produced every two to three months. Activities and external visits are positive with giving residents the opportunity to remain involved in the community.

What has improved since the last inspection?

A pre admission assessment form for residents who are considered for intermediate care has been developed. This enables the manager to assess the needs of the resident to ensure the care plan is created, based on specific care needs. Resident contracts are available as an additional requirement from the last inspection. This document ensures that all residents are clear about what the home offers.

What the care home could do better:

The home operates to a good level and no requirements were made on this occasion therefore there are no comments to be made in this section.

CARE HOMES FOR OLDER PEOPLE Ashmore Nursing Home Barningham Road Stanton Bury St Edmunds Suffolk, IP31 2AD Lead Inspector Iain Smith Unannounced 28th June 2005 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. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ashmore Nursing Home Address Barningham Road Stanton Bury St Edmunds Suffolk IP31 2AD 01359 251681 01359 251681 None Ashmore Nursing Home Limited 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 D Groom CRH 23 Category(ies) of OP - 23 registration, with number of places Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06.12.04 Brief Description of the Service: Ashmore Nursing Home is privately owned and has provided care and accommodation since 1993. The Home is Registered under the Provisions of the Care Standards Act 2000 to accommodate 23 older persons. Ashmore Nursing Home is situated in Stanton, which is approximately 10 miles from both Diss and Bury St Edmunds. The Home is detached and provides accommodation on two floors which is accessible by shaft lift. There are 19 single and 2 double bedrooms. The double bedrooms do not meet the spatial requirements and planning permission has been approved for an extension. The double bedrooms will be closed and refurbished to provide office and storage space. All bedrooms benefit with en-suite facilities. Service users have access to four communal toilets that are conveniently located within the Home close to communal facilities. Three of these toilets provide disabled facilities. The lounge, dining room and conservatory all have views of the garden that are laid to lawn, with attractive flower beds and a walled garden in a tranquil setting. Car parking is available to the front of the Home. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was arranged as an announced inspection, the first inspection for the year 2005/2006. The visit commenced at 08.45 and lasted three hours and was conducted by Iain Smith, Regulation Inspector. During the inspection residents were spoken to in addition to the catering, housekeeping and care staff. On the inspection day the home received a student nurse audit visit from two assessors. Both of the assessors were spoken to as part of the CSCI inspection. The manager was present throughout the inspection and contributed fully to the inspection process. A tour of the premises was made and communal areas visited. Care plans were read and two staff files were examined. What the service does well: What has improved since the last inspection? A pre admission assessment form for residents who are considered for intermediate care has been developed. This enables the manager to assess the needs of the resident to ensure the care plan is created, based on specific care needs. Resident contracts are available as an additional requirement from the last inspection. This document ensures that all residents are clear about what the home offers. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 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. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 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 Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 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) 1,2,3 and5. People who use the service receive clear information to enable them to make a choice about whether or not they wish to live in the home. Each residents needs are assessed prior to moving into the home. EVIDENCE: The statement of purpose and service user guides were available in the foyer of the home. The manager stated that all prospective residents receive this information. One resident who lives in the home with his wife stated that they choose the home following a visit to the home. The home provides terms and conditions for residents. There was evidence in the care files, including a social services contract. Two residents contracts were seen and the information included that which informed residents about the home. The two care plans that were examined included a pre admission assessment. These assessments identified the health care needs for example personal care, medication and mobility. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 9 The staff met the needs of the residents. This was demonstrated in the training and development files. Examples of the training were management of continence and pressure sore prevention. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 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) 7,8 and 10. Resident’s needs were assessed and care planning was completed therefore ensuring that staff delivered the appropriate care to each resident. EVIDENCE: Two care plans were examined to assess the care needs of the residents. The care plan was arranged in sections to include the identified need, goal and aim and action to be taken by the staff to ensure the need to met. An example of one need was to maintain healthy skin. The appropriate risk assessments were completed. The staff assessed that the residents incontinence and with restricted mobility, there was a high risk of skin breakdown. A pressure mattress was used to assist the resident with the care and comfort required to meet the needs. The plans were reviewed monthly, signed and dated. Nutritional assessments were evident in the two care plans examined. Privacy and dignity were maintained in the home, staff were seen to knock on bedroom doors before entering. Residents were also addressed by their preferred name. One resident said ’I am wearing my own clothes and the carer helped me dress.’ . Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 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 and 15. The home offers daily activities and encourages residents to fulfil their cultural and recreational needs. Meals are planned and prepared specifically to meet the needs of all residents. EVIDENCE: Leisure and social activities are displayed in the foyer of the home. On the day of inspection six residents were preparing to take a boat trip on Oulton Broad. The manager stated that an additional four boat trips were organised through the summer period. Residents attended a trip to Duxford Air Museum in June 2005. A number of activities were arranged in the home, for example, games and puzzles. One resident was seen in the lounge reading a newspaper, another was doing a crossword puzzle. A variety of food was available at breakfast. Two residents selected fruit and another a piece of toast. The chef prepared lunch with the assistance of a catering assistant. The lunch menu was sausage and onion plait or cheese and onion slice. Both course were served with cauliflower cheese and potatoes. One resident said ‘there is plenty of food here’ and another resident said ‘the food is good.’ Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 12 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 and 18. Arrangements are in place to minimise risk so that the safety and welfare of the residents are promoted. The policies and procedures of the home ensure the residents are safeguarded from abuse and harm. EVIDENCE: No complaints have been received since the last inspection. The complaints and protection of vulnerable adults policy were available in the home for staff to refer to in addition to the inclusion in staff induction. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 13 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) 19,23,24,25 and26. The home offers a safe and comfortable environment to all residents where policies and procedures are in place to protect all those who live there. EVIDENCE: The home offers an environment where residents can sit in a main lounge area close to the front entrance or spend time in the dining room. Each of the three bedrooms visited contained the resident’s personal possessions. Pictures, ornaments and books were evident in the rooms where a bedside cabinet and table were available for the resident. One resident said’ the home is very pleasant.’ The home was seen to be clean, tidy and free from offensive odours. There was a selection of chairs in the lounges and carpet was seen throughout the home. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 14 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) 27,28,29 and 30 The staffing numbers and skill mix are appropriate for the home. The training and development is relevant and gives the staff the skills and experience to meet the needs of each resident. EVIDENCE: The staff rota was examined and found to include one trained nurse on each of the three shifts over a 24-hour period. In addition to the trained member of staff there were four carers on the morning shift, three in the afternoon and two at night. The housekeeping and catering rota indicated the appropriate number of staff on duty. The home is committed to the staff undertaking NVQ training. Seven staff have achieved level 2 and two at level 3 with another seven staff waiting to commence their training. The recruitment process was assessed with the examination of two staff files. The files contained an application form, two references and copies of training certificates. A criminal records bureau (CRB) enhanced checks were evident for both members of staff. The training and development of staff is positive in the home. The training records show that induction is completed for all new staff in addition to specialist training for example manual handling and promotion of continence. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 15 The home accommodates student nurses who are on placement from the Suffolk College of Nursing. The homes therefore have to adhere to a requirement of the college to provide learning outcomes for the students. This includes providing learning materials, books and videos. The student nurses are involved with reading the care plans and are involved with some aspect of care, under the supervision of a trained nurse. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 16 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) 31,32and 36 There is clear leadership within the home and that ensures residents receive consistent quality care through training and communication. EVIDENCE: The manager is a trained nurse, registered with the Nursing and Midwifery Council (NMC). They have completed their NVQ level 4 and has attended a number of update training sessions. Staff supervision was evident, both in the staff files that were examined and that two staff stated that they receive the supervision at least two monthly. Issues discussed in staff supervision include resident care and training and development. The home’s manager encourages an open and positive atmosphere and this was further demonstrated with staff meetings evident. Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 17 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x 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 Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x x Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 18 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 Regulation None 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. 1. Refer to Standard None Good Practice Recommendations Ashmore Nursing Home I54-I04 S24327 Ashmore V239035 050628 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 5th Floor, St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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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