CARE HOMES FOR OLDER PEOPLE
Ashmount Residential & Nursing Home 10 Southey Road Worthing West Sussex BN11 3HT Lead Inspector
Miss Helen Tomlinson Unannounced Inspection 17th November 2005 1.40pm 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 Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ashmount Residential & Nursing Home Address 10 Southey Road Worthing West Sussex BN11 3HT 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) 01903 538500 01903 528502 Guild Care Miss Alison Lynne Wiles Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Ashmount is registered to provide personal and nursing care for up to fifty people aged 65yrs and over. It is a large detached property situated in a residential area of the seaside town of Worthing. The sea front and shopping areas are a short walk away. There is a small private car park at the front of the home and a garden at the back. Accommodation is provided on 3 floors. A passenger lift allows access to all floors. Large communal sitting and dining areas are available on the ground floor. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector arrived at the home at 1.40pm and remained until 7pm. The registered manager was present until 4pm. At the time of the inspection the home was fully accommodated. Twenty-two of the residents were receiving nursing care and twenty-five personal care. Over the course of the inspection twenty residents, eight staff and five visitors were spoken with. Residents were seen both in the communal areas of the home and the privacy of their own bedrooms. Six residents files were examined in detail and others were seen for specific information. Other records were looked at, a tour of the premises took place and care practices observed. One staff file was examined. During a tour of the premises the inspector noted that storage of equipment, in a first floor bathroom, was spilling out onto the corridor and causing a hazard to residents and staff. This had been noted at the last inspection and a requirement made that all storage be made safe. Due to the potential risk of this unsafe storage an immediate requirement was issued, that this area be made safe. At 4.45pm the bathroom had been closed and locked to prevent residents access and ensure their safety. A letter was sent to the Responsible Individual regarding the reduction in bathrooms this presented and he was required to write to the Commission with future plans. What the service does well:
Residents said the home was “very clean” and “you won’t find a spec of dust anywhere.” Visitors said staff were very friendly and helpful. They said they were kept informed about their relative’s condition and any changes. They were welcomed into the home at any time. One visitor said they had asked for shelves and things to be put up in the bedroom and this was done very quickly. There was a good understanding of the need to make the room attractive and homely to make the resident feel at home. Residents said the staff were very nice and kind. It was described as “home from home.” They said there were no restrictions on times to get up or go to bed, this was their choice and staff respected it. Resident’s preferences were recorded on their care plans. In some instances this contained a lot of detail, particularly with the night care. Residents said they liked the one to one which was provided for activities, particularly to go out of the home. They were happy to get this “special” time. Resident’s benefit from staff who receive appropriate training. This includes the statutory training and additional training to meet individual residents needs.
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 6 There are a good number and variety of quality reviews undertaken which include the residents and visitors views. Residents said the food was good and they enjoyed their meals. What has improved since the last inspection? What they could do better:
An area of concern was noted in relation to the administration of medication. Medications written on the administration charts, as regular medication had not being given for two residents receiving nursing care. The nurse in charge said these had been discontinued by the G.P. This was not recorded on the chart and it looked as though the qualified nurses had not given prescribed medication. Any change in medication must be written on the administration chart and cross referenced to the visit or phone call when the change was made, by an appropriate medical person. The registered manager confirmed, the following day, that these two instances had been investigated with the G.P. involved and clarification sought as to the present situation with this medication. She informed the inspector that all medication sheets would be examined and any discrepancies investigated with the G.P. Charts were used to document the fluid intake and output, change of position and personal care of the residents receiving nursing care. These were not fully completed, with no information being provided for long periods of time during the day. The use of these charts should be reviewed and staff reminded of the importance that residents receive this care. The care plans seen had not been reviewed at appropriate intervals to make sure they contained correct information for the current condition of the residents. The plans should always be up to date and consistent with the resident’s needs. Two issues of maintenance were brought to the attention of the registered manager. One of these, a hole in a bedroom wall, had been raised at the last inspection. This had received some repair, but the hole remained. All areas of the home should be kept in a good state of repair. Some hazardous cleaning solution was present in areas accessible to residents. These should be stored securely at all times.
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 7 Some areas of the home and rooms had offensive odour. These were discussed with the registered manager. One of the areas had been presenting an issue for some time, despite various methods being used to eliminate the odour. The manager stated alternative flooring was being replaced in this area. The ground floor bathroom had a razor and nailbrush on the bath side. These should not be used for more than one resident to prevent the spread of infection. These items should be removed from the bathroom. Some bedroom doors were held open with wedges. This does not meet with the guidance of the fire service and must cease. The majority of fire doors were held open with devices which met the guidance of the fire service and these should be used for all doors. During and following supper there was a lack of supervision of the residents on the upper floors. The staff numbers and deployment at this time should be reviewed. The method of managing the resident’s personal money does not meet with the requirements currently. This is due to the procedure followed by the organisation and they are aware of the need to change the current system. The accident records had documentation that there would be no follow up to some accidents which clearly did require further investigations and actions to be taken in order to prevent a re-occurrence. Later in the afternoon, when it went very cold outside, some areas of the home were cold and some residents said they felt it was cold in the home. A small number of the radiators were cold and staff reported there was sometimes a problem with the heating. Several windows, in both residents’ bedrooms, lounges and bathrooms, were open. The home should be kept warm at all times, to suit the needs and wishes of the residents. 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. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 8 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 Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 9 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 Up to date information about the services and facilities of the home was available. EVIDENCE: Since the last inspection a new Statement of Purpose had been produced. This contained all information necessary for prospective residents and others to understand the facilities and services offered. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 the following standard(s): 7,8 and 9 All residents had a plan of care. This was not always up to date with their current needs and healthcare. Residents healthcare needs were met though documentation did not always support this. The medication administration records indicated that not all residents were given medication as prescribed. Registered nurses were not working within their code of practice. EVIDENCE: All residents accommodated in the home had a plan of care documented. This contained information about both their social and health care needs. Those seen had not been regularly reviewed and in some instances did not contain necessary information to understand the care that resident currently required. One resident had been to hospital for a procedure which had an effect on their eating and drinking, nutritional needs and general wellbeing. There was no information about this in the care plan. There had been no review of the plan following this and no action was included as to any change in the resident’s needs. For two other residents a change in behaviour had necessitated a reassessment of their needs. There was no information regarding the management of this behaviour, the effect on the resident, staff or other
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 11 residents, and no indication of the approach to be taken. There was a chart included to document episodes when the residents were unsettled, but these had been used to document other information. The health care assessments, which inform the plan of care, had not been reviewed. For one resident their pressure sore risk assessment had been completed on 17/8/04 with no review. For another a falls risk assessment had been reviewed on 28/7/02 and not since. An example of good practice was seen where the falls risk assessment was reviewed regularly and following any fall. All assessments and plans of care must be reviewed regularly and kept up to date. They must reflect the current situation with that resident and provide sufficient information for the staff to deliver the necessary care. The residents receiving nursing care had charts kept outside of their bedrooms with information regarding their food and drink intake, their urine output, the changes of position to prevent pressure sores and the personal care they had received. These charts were used over a twenty-four hour period. The charts seen were not completed and indicated that the resident had received poor care. For one there was only 100mls of fluid given for a twenty-four hour period, for another there was none. One resident was assisted out of bed to the chair at 8am and back to bed at 8.45pm with no movement in between. It was discussed with the registered manager that the use of these charts should be reviewed and where they were to be used they must be kept up to date. The residents must receive the care they require to meet their health and personal needs and be comfortable at all times. On examination of the medication administration record sheets it was seen that medication which was prescribed on a regular basis was not given. The nurse in charge said the prescriptions had been changed by the G.P. There was no evidence of this and it was unclear how long ago this had occurred. It was discussed with the nurse that records of any change in medication, by any professional, must be kept and cross-referenced to the medication sheet. The medication sheet must be up to date with the resident’s current prescription. The following day the nurse in charge confirmed that, for the residents highlighted at the inspection, their prescriptions had been checked with the G.P. and were correct. The registered manager said that all residents’ administration sheets would be brought up to date. It was discussed that the Registered Nurses in the home were working outside of their code of practice, by not giving medication as it was prescribed by the G.P. The medication administration sheets for those residents receiving personal care were up to date and the residents had received their medication as prescribed. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 the following standard(s): 14 and 15 Residents said they were able to make choices about their lives within the home. Residents were satisfied with the food provided. The complaints about the service at mealtimes, received at the last inspection, were not present at this inspection. EVIDENCE: Residents said staff asked them what time they liked to get up, go to bed, where to eat their meals, whether to be alone in their bedrooms or in the communal areas and how to be assisted and supported. They said the staff respected their choices. Some of this information was recorded in the individual plan of care. When the resident first became accommodated at the home information about their preferences was recorded. Some of the care plans contained detailed information about how the resident liked to be supported, particularly those for care at night. For the more dependant residents, who were unable to discuss their own preferences, relatives said they had been consulted and invited to inform staff of the resident’s choices. Information about the advocacy service was available in the home. Residents said the food served in the home was generally good, with a choice offered and plenty of food given at mealtimes. At the last inspection residents complained about the long wait for food, whilst sat at the table, particularly at lunchtime. At this inspection residents told the inspector that this had
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 13 improved and none complained about this issue. The chef said the routine for serving meals had changed to try to eliminate this wait. A kitchen assistant had been employed and they did some tasks, such as supplying water jugs to the residents, which would have been done by the care assistants previously. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed. Standards 16 and 18 were assessed at the last inspection and were met. EVIDENCE: Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,24,25 and 26 The environment was suitable to meet the needs of the residents. Some areas had been redecorated since the last inspection. Some issues of maintenance were noted and one of fire safety. Residents have access to a variety of safe and comfortable communal space. Suitable toilets and bathrooms were available. Equipment needed to meet the needs of the residents was available. Resident’s bedrooms were homely and suitable to meet their needs. There was an issue regarding the heating in some areas of the home. The home was clean. An offensive odour was present in some areas. EVIDENCE: At the last inspection a requirement was made regarding the wear and tear of some areas of the home, particularly the first floor corridor. At this inspection this area had been redecorated and was much improved. The requirement included a hole in one bedroom wall. Although a repair had been made to the wall, since the last inspection, the hole was still present. One cupboard door in a bathroom was not secure. These issues of maintenance must be made safe. The residents and visitors praised the maintenance man who assisted in
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 16 putting up shelving, photographs and other personal items and equipment to make their bedrooms homely. They said this was done promptly on asking and the importance of this, to the resident, was understood. The majority of fire doors in the home were closed or secured open using devices which met with the guidance of the fire service. Several bedroom doors, on the second floor particularly, where wedged open. The residents said they wanted their doors to be kept open. For these residents alternative devices must be used and no fire doors should be wedged open. Residents could chose from a variety of communal space to sit in during the day. There is one large lounge at the front of the house, a seating area close to the office and kitchen and a conservatory on the side of the house. A smaller lounge was in use by residents watching a film on video. A large dining area is used for meal times. Residents said they could chose whether to sit in these areas or stay in their own bedrooms. Toilets and bathrooms were situated close to the resident’s bedrooms and communal areas. These were large enough to accommodate equipment necessary for some residents. Commodes were present in the bedrooms of those residents who needed this. Assisted baths were available for residents who require this. As discussed in the summary one bathroom on the first floor was used for storage and was closed off to residents, during the inspection, in order to safeguard them. The responsible individual is required to inform the Commission of the future plans to make sure sufficient number of bathrooms, with appropriate equipment, are available to the residents in that area. Other equipment needed for the residents, was present in the home. This included hoists and other lifting equipment. Residents said they liked their bedrooms and they were made homely and welcoming. They could bring in personal possessions from home in order to help them settle. Residents had a variety of their own possessions including televisions, photographs, furniture, pictures, tea and coffee making facilities and telephones. Residents said they found the home comfortable, but some complained, later in the afternoon, that they felt cold. It was a very cold evening and some areas of the home were not warm. Some residents said they had an “extra cardigan” or “blanket” on to keep warm. Some of the radiators in the lounge, dining room and individual bedrooms, were cold. Staff said there was sometimes a problem with the heating. Several windows were still open at 6pm, including individual resident’s bedrooms, lounges and bathrooms. Some of these residents could not close their own windows. The registered manager was asked to investigate the heating situation and remind staff it was part of their duty to make sure the residents were warm enough at all times. Residents said they home was always clean and tidy. They commented that they were happy with the general cleanliness of all areas of the home. An offensive odour was present in one corridor and one bedroom of the home. The registered manager stated this was being dealt with by the treatment of the flooring and provision of an alternative. The care home should be free from offensive odours at all times. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 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 and 30 The number of staff appeared adequate for the residents accommodated. The deployment of staff at suppertime should be reviewed. The recruitment procedures protect the residents. Resident benefit from staff who have received training to meet their needs. EVIDENCE: On the day of the inspection on upstairs floors there was a lack of supervision over suppertime and afterwards when clearing up. Residents became restless and staff were busy with assisting residents to eat or moving them from the dining room. This led to the poor practice of one carer “doing tops” because her partner was “tied up.” This meant residents were assisted to be washed and changed on their top half whilst left sat in the chair, in their bedrooms, waiting to be assisted into bed. These were the more dependant residents who required two care assistants to move into bed. This is not good personal care of the residents, is not dignified and is organised for the good of the staff and not the residents. The staff deployment at this time must ensure that this practice does not take place. The registered manager was advised to use the Residential Staffing Forum as guidance for the number of staff needed to meet the needs of the residents appropriately. At the last inspection a requirement was made regarding the recruitment of staff. At this inspection one staff file, of a member of staff employed since the last inspection, was examined. This contained all information needed and the necessary checks to make sure the residents were safeguarded, where in place.
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 18 Residents said the staff were able to meet their needs. Staff said they received a good amount of training, which was relevant to their daily work. Records were seen of induction training. This covered all relevant areas. Guild Care, the organisation which owns the home, has a training department. The registered manager said they informed her when individual staff training needed to be updated and gave dates for this training to take place. Fire safety training was taking place on the evening of the inspection. Specific training was provided in order to meet individual resident’s needs. This included nursing needs and specialist nurses from the hospital supplied this training. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 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): 31,33,35 and 38 The registered manager has the skills, knowledge and experience to run the home. The quality of care provided was reviewed appropriately. The current procedures do not safeguard the personal finances of the residents. Some practices in the home did not safeguard the health and safety of the residents. EVIDENCE: The registered manager has been in post since July 2001. She had worked for Guild Care for eleven years prior to this, as a registered nurse. She is a Registered General Nurse and has completed her Registered Managers award. Staff, residents and visitors said they would approach the manager to ask advice and felt she was knowledgeable about the running of the home and care of the residents generally.
Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 20 There were various systems in place to review the quality of care provided to the residents. These included regular audits, by both the manager and higher management from Guild Care. Residents, relatives and professionals were involved in the quality reviews, by completing questionnaires and having opportunities to attend meetings. The registered manager was involved in the reviews of quality of service and provided reports to Guild Care management to present their progress. Residents said they could approach the manager or any staff informally if they were not happy with any aspect of the service provided. Some personal monies for most residents are kept centrally at the home. The organisation has an accounting system set up on the computer. Records were kept of the individual residents money and receipts were produced. The resident’s personal money was pooled together and some was held in a bank account, in the name of the organisation, until the individual requested it. It was discussed, with the person in charge, that this did not meet the regulations and no money must be kept in a bank account, unless it is in the name of the resident. The administrator explained that a change in the system was imminent which would solve this issue. The operations manager, for all the Guild Care homes, is aware of this issue and is working to meet the Regulations. The issues concerning the health and safety of the residents are highlighted throughout the report. These include some fire doors being wedged open, unsafe storage of items and hazardous substances, potential of infection control issues and lack of supervision of residents at suppertime. It was discussed with the registered manager that it is the duty of all staff to safeguard the health and safety of the residents at all times. They should be reminded of this part of their daily work. A requirement was made at the last inspection regarding the fitting of window restrictors, on a risk assessment basis. The registered manager stated this had been done. The accident book was examined. Accidents were recorded and a sheet for recording the outcome was present. For the majority of accidents this said “no problem, no follow up.” It was discussed that this was misleading as in some instances follow up was necessary to prevent a recurrence of the accident. The recording of the outcome and any action taken should be reviewed. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 3 3 2 3 x 2 2 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 3 x 3 x 2 x x 2 Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 22 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 OP7 Regulation 15 Requirement Timescale for action 30/08/05 2 OP8 14(2)(a) 3 OP19 23(2)(b) 4 OP19 23(4)(c The resident’s plan of care must be kept under review. It must reflect the current situation and be drawn up in consultation with the residents. This requirement remains unmet since the inspection of 29/6/05. The timescale given of 30/08/05 has expired The health care needs of the 30/08/05 residents must be met. Any health care assessments must be kept under review. This requirement remains unmet since the inspection of 29/6/05. The timescale given of 30/08/05 has expired The hole in a bedroom wall must 30/08/05 be repaired. All areas of the home must be kept in a good state of repair. This requirement remains unmet since the inspection of 29/6/05. The timescale given of 30/08/05 has expired All fire doors must be kept 30/11/05
DS0000024106.V265798.R01.S.doc Version 5.0 Ashmount Residential & Nursing Home Page 23 )(i) 5 OP22 23(2)(l) 6 OP25 23(2)(p) 7 OP35 20(1) closed or devices which meet the guidance of the fire service used to keep them open. All equipment must be safely stored at all times. An immediate requirement was issued during the inspection and met on the day. All parts of the care home must be kept warm enough, at all times, to meet the needs of the residents. The registered person shall not pay money beloning to a resident into a bank account unless the account is in the name of the resident to which the money belongs. 17/11/05 10/12/06 31/01/06 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 3 4 5 Refer to Standard OP21 OP26 OP27 OP35 OP38 Good Practice Recommendations The responsible individual should write to the Commission and inform them of future plans for the provision of suitable and sufficient bathrooms. The care home should be free from offensive odours at all times. Residents must be assisted to prepare for bed in an appropriate manner, which protects their dignity. Resident’s personal money should not be pooled. It should be kept separately in a secure place. The duty of all staff to safeguard the health and safety of the residents in their care should be reviewed. Ashmount Residential & Nursing Home DS0000024106.V265798.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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