Inspection on 05/12/05 for Ashridge Court Nursing Centre

This inspection was carried out on 5th December 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

Ashridge Court Nursing Centre 15/10/07

Ashridge Court Nursing Centre 18/04/06

Ashridge Court Nursing Centre 26/07/05

Ashridge Court Nursing Centre 16/12/04

Ashridge Court Nursing Centre 25/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Ashridge Court Ltd 163 Barnhorn Road Bexhill On Sea East Sussex TN39 4QL Lead Inspector Niki Palmer Unannounced Inspection 5th December 2005 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 Ashridge Court Ltd DS0000013956.V269993.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. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashridge Court Ltd Address 163 Barnhorn Road Bexhill On Sea East Sussex TN39 4QL 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) 01424-842357 01424-848570 Ashridge Court Limited Mrs Elizabeth Teresa Van Eugen Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (34) of places Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is thirty four (34). That the care home provides general nursing care to older people over the age of sixty five (65) and those with a physical disability. 26th July 2005 Date of last inspection Brief Description of the Service: Ashridge Court is located on the main road between Eastbourne and Bexhill, approximately half a mile from Little Common Village. Local amenities are accessible by public transport. Ample parking is available at the front of the property. The home is situated in well-maintained gardens that have extensive views to the rear of the property overlooking a large pond, Cooden Beach golf course and the coastline. The home is accommodated over two floors, which are accessible by a passenger shaft lift. The home comprises of 32 single bedrooms, 27 of which have en-suite facilities and one double room. The nursing centre is divided into two wings (East and West), which are staffed separately from each other. The property is currently in the process of having building works carried out to create 12 additional bedrooms to the rear of the property, although this will only accommodate a further eight residents as four of the current rooms in use will become a new dining area on the first floor of the East Wing. Other existing bedrooms will be extended to provide en-suite facilities. It is anticipated that this work will be completed by July 2006. The home is registered to provide nursing care to older people as well as those who may have a physical disability. The Nursing Centre is owned and managed by Mr and Mrs Van Eugen. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 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 Ashridge Court will be referred to as ‘residents’. This unannounced inspection took place on Monday 05th December 2005 between 10.00am and 4.45pm. The inspection began with discussions with one of the administrative staff and one of the Registered Providers in respect of progress made since the last inspection, followed by the examination of three care records. In order to gather evidence on how the home is performing, individual discussions took place with four residents, three nursing staff, one carer, three visiting relatives and a Community Psychiatric Nurse (CPN). An inspection of the premises and its facilities also took place. 31 residents were accommodated at the time of the inspection. Other records and documentation inspected included: the home’s Statement of Purpose and Service Users’ Guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, quality assurance systems and health and safety records. In order that a balanced and thorough view of the home is obtained, this inspection report should to be read in conjunction with the previous inspection report carried out on 26th July 2005. What the service does well: What has improved since the last inspection? A thorough Occupational Therapy audit and report was completed in September 2005. The outcome of which was very positive. Cleaning materials are now stored securely in order to safeguard residents from harm and additional storage has been created to ensure that all bathrooms are kept free of clutter. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 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. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 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 Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 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 and 3. Whilst adequate written information is available to prospective residents in order to help them choose whether or not the home is suitable, the home’s pre-admission procedures are poor and fail to identify how the home can meet assessed needs. EVIDENCE: Ashridge Court has a detailed Statement of Purpose and Service Users’ Guide in place, which is kept on display in the main entrance area of the home. This was last updated in August 2005. It contains details of the home’s core values and aims and objectives, terms and conditions of contract, the arrangements in place for dealing with complaints and the relevant qualifications and experience of staff, however this was not current. All residents and their relatives spoken with said that they had received ample written information about the home, prior to making a decision to move in. One of the residents spoken with said that her daughter had helped her to make a decision to move in to the home based on the home’s previous inspection report that she had read on the Internet. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 9 Two recent pre-admission assessments were seen on the day of inspection. The home uses a recognised nursing assessment (Standex). The first assessment gave a very brief overview of the individual’s needs and medical history, but did not identify who had completed the assessment, where it took place, or when. The second had also not been signed or dated, however did provide adequate details of the persons specialist nursing needs and there was evidence to show that specialist advice and training had been sought prior to admission. It was concerning to note that the person completing the assessment had not considered the individual’s communication needs. It simply stated the person was ‘unable to speak’. There was no other information available regarding their cognitive abilities or how they expressed pain. It remains an outstanding requirement for the home to review its preadmission procedures to ensure that thorough details of individuals’ medical, social and personal care needs are recorded. Ashridge Court Ltd DS0000013956.V269993.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, 10 and 11. Limited progress has been made to ensure that the health care needs of residents are identified and met. These shortfalls have the potential to place residents at risk. EVIDENCE: Individual plans of care are available but little progress has been made to ensure that all aspects of healthcare needs are identified within individual plans of care. Whilst assessments are in place for nutritional screening and pressure area care, there is no guidance for staff to follow in order to improve and maintain individual’s diet, or ensure that residents’ pressure areas are regularly changed. In one instance records had not been completed for the last 10 days. It was also concerning to note that the management of wound care dressings had not been specified within individual care plans. Discussions with nursing staff suggested that they are aware of how often the dressings need to be changed and the type of dressing, however this approach is dependant on the knowledge and memory of nursing staff. Residents spoken with confirmed that staff treat them at all times with dignity and respect. Indeed this was evident on the day of the inspection. Each of the Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 11 residents are addressed by their preferred term and have all personal care needs carried out in the privacy of their own rooms or bathrooms. Since the last inspection the home has devised a comprehensive policy for care of the dying and terminally ill, however this is specific to nursing staff and not residents or their relatives. The Registered Manager confirmed that despite approaching residents and their relatives to determine their personal wishes in the event of death, this has been most difficult and upsetting for some. Consequently not all residents’ wishes are recorded. The home should consider compiling written information specifically for residents and their relatives in order to determine their wishes. Ashridge Court Ltd DS0000013956.V269993.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): Over recent months the provision of food has been poor. EVIDENCE: Although none of the above standards were assessed during this inspection, many of the residents spoken with commented on the fact that since the previous chef left, the standard of food has fallen. Following his departure, a number of supply cooks were employed up until the beginning of November when a new full-time person was appointed. Residents stated that since this time, the new chef has consulted with them regarding their preferences and they feel that the standard of food has begun to improve. On the day of inspection the chef was not working and the Registered Manager of the home was preparing the lunchtime meal. It must be noted that a vegetarian option was provided at short notice for the Inspector on the day of inspection, which was good. This standard will be followed up at subsequent inspections. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The home has inadequate systems in place to ensure that all verbal complaints are dealt with appropriately. Written policies and procedures are outdated and therefore do not safeguard residents from harm. EVIDENCE: The home has a complaints procedure in place. Despite a number of residents stating that they had complained to the home in respect of the provision of food and current building works being carried out, written records of verbal complaints are not kept and were therefore unavailable for inspection. A requirement has been made in respect of this. The home has a detailed adult protection policy/procedure and whistle-blowing policy in place. These specify what constitutes abuse, how to recognise it and who to report suspected abuse to, however the adult protection alerting procedure is not in accordance with local multi-agency guidelines. It needs to be amended to state that Social Services are now the lead agency. Staff spoken with were able to demonstrate a good awareness of the protection of vulnerable adults. No alerts have been raised since the last inspection. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, and 26. Ashridge Court provides residents with a warm, comfortable and homely place to live. EVIDENCE: Ashridge Court is a large well-maintained care home separated into two wings – East and West. Only one bedroom is considered to be of double occupancy, however on the day of inspection it was accommodated by one resident. During the inspection of the premises a number of bedrooms and bathrooms were viewed. It was pleasing to note that since the last inspection cleaning products and additional bedding are now stored appropriately and all extractor fans were found to be working. Building works started in November 2005 to create an additional 12 bedrooms to the rear of the property. This will only accommodate a further eight residents as four of the current rooms in use will become a new lounge and dining area on the first floor of the East Wing. Other existing bedrooms will be extended to provide en-suite facilities and patio doors with views over the Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 15 garden and coastline. It is anticipated that this will be completed by July 2006. A second planning application has been submitted to Rother District Council to create a further eight rooms increasing its total occupancy to 50 residents. In addition the plans propose a new treatment room, laundry area and garden lounge. This is currently being processed. At the last inspection residents and their relatives raised concerns in respect of the disruption that the building works may cause. Although some commented that it is often ‘noisy and disturbing’, no major concerns were raised on the day of inspection. This was pleasing to hear. An occupational therapy audit and report was completed in September 2005. A copy of which, was available for inspection. The vast majority of rooms and communal areas were seen. A number of recommendations were made for example improving access from the ground floor rooms with the provision of ramps, but on the whole the report was very complimentary and positive. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 28, 29 and 30. The procedures for the recruitment of staff have improved. This helps to ensure the safety of residents living in the home. EVIDENCE: Of the 13 care assistants employed four are trained to at least NVQ level 2 in care, whilst five are currently working towards this. Ashridge Court employs overseas carers via a recruitment agency, many of whom are qualified nurses in their own country who wish to do their adaptation training in the UK. Two newly appointed members of staff recruitment files were seen on the day of inspection. It was pleasing to note that both contained all the required employment checks such as: written references, proof of identity, POVA First and Criminal Record Bureau checks prior to starting work. All newly appointed staff confirmed that they had received a thorough induction process during their initial six weeks of employment. Records evidenced this. A recommendation has been made for the Registered Manager to consult with the home’s professional body in respect of the new Common Induction Standards issued by Skills for Care (replacing TOPPS). Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 17 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): 33, 37 and 38. Ashridge Court has adequate management and administration systems in place to ensure that the home is run in the best interests of the residents. EVIDENCE: Residents’ questionnaires are given out on a regular basis, however the numbers of those that return the completed form is small. The home is reliant on residents’ meetings to seek feedback - which works well. Recommendations have been made for the home to seek the views of visiting professionals and consider placing a suggestions box in the entrance area. All feedback obtained, including verbal compliments/complaints must be published and made available to the residents. This is outstanding from the previous inspection report. A recommendation was made in the previous inspection report for the home to consider adapting their policies and procedures specific to the home. This has Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 18 yet to be actioned. It was noted that some of the home’s procedures still state the National Care Standards Commission (NCSC). A requirement has been made for these to be updated and amended to show the current contact details of the Commission for Social Care Inspection (CSCI). A number of the home’s health and safety checks and certificates were seen. It was pleasing to note that all equipment is regularly maintained and serviced. Certificates seen included the homes: fire extinguishers, lift service, nurse call system and emergency lighting. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 3 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 X 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X 3 X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X 2 3 Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP1 OP3 Regulation 4(1)(c) & Sch 1(3) 14(1)(2) Requirement That the current Statement of Purpose and Service users’ Guide is displayed within the home. That the home review its preadmission assessment document to ensure that it allows the assessor to gain thorough details of individuals medical, social and personal care needs [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION]. All residents must have a plan of care to ensure that all aspects of health, personal and social care needs are met [THIS IS OUTSTANDING FROM THE TWO PREVIOUS INSPECTIONS]. That details of any specialist interventions required e.g. for the management of nutrition, pressure area care and wound dressings are specified and recorded [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION]. That residents wishes concerning terminal care and arrangements in the event of death are determined and DS0000013956.V269993.R01.S.doc Timescale for action 31/03/06 31/03/06 3. OP7 12(1) 15(1) 31/12/05 4. OP8 12(1a&b) 13(1b) 31/12/05 5. OP11 12(2&3) 31/03/06 Ashridge Court Ltd Version 5.0 Page 21 6. 7. OP16 OP18 22(3) 12(1)(a) 8. OP33 24 9. OP37 17 recorded [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION]. That a record of all verbal complaints is kept and made available for inspection. That the home updates its Adult Protection policy and procedure in line with local multi-agency guidelines. It needs to state that Social Services are now the lead agency and provide the relevant contact details. All results of residents, relatives and visitors questionnaire surveys must be published and made available [THIS IS OUTSTANDING FROM THE RPEVIOUS INSPECTION]. That all policies and procedures are amended to provide the current contact details of the CSCI. 05/12/05 31/12/05 31/03/06 31/03/06 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. Refer to Standard OP11 Good Practice Recommendations That the home compile written information specifically for residents and their relatives in relation to determining their wishes in the event of terminal care and following death [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION REPORT]. It is recommended that the Registered Manager consult with the home’s professional body in respect of the new Common Induction Standards issued by Skills for Care (replacing TOPPS). That the home considers the reasons as to why response from residents questionnaires is low and revise if necessary [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION REPORT]. DS0000013956.V269993.R01.S.doc Version 5.0 Page 22 2. OP30 3. OP33 Ashridge Court Ltd 4. OP37 The home should consider adapting all policies and procedures in order to make them specific to the home [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION REPORT]. Ashridge Court Ltd DS0000013956.V269993.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office 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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