Inspection on 12/10/06 for Ashton Court Care Home

This inspection was carried out on 12th October 2006.

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

Other inspections for this house

Ashton Court Care Home 29/09/08

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

CARE HOMES FOR OLDER PEOPLE Ashton Court Care Home 56 Three Tuns Road Eastwood Nottingham NG16 3EJ Lead Inspector Steve Keeling Unannounced Inspection 3rd October 2006 09:00 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 Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 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. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton Court Care Home Address 56 Three Tuns Road Eastwood Nottingham NG16 3EJ 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) 01773 712017 Hearn Care Homes Limited Vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (3) of places Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Restriction of PD beds to 3 Within the total number of beds a maximum of 3 beds only may be used for the category of PD of 50 years or above. 10/10/06 Date of last inspection Brief Description of the Service: Ashton Court Care Home is situated within walking distance of Eastwood town centre, which has a range of shops, post office, public houses and a library. Ashton Court provides residential care services for 35 older people. The home is also registered to accommodate three people with a physical disability. The facilities within Ashton Court are suitable to achieving optimum independence for the service users. Wheelchairs can access all areas within Ashton Court. Mobility aids are available, such as hoists, transfer belts and strategically placed handrails. A walk-in bathing area is available if required. A vertical lift is also accessible to allow easy access to the first floor of the home. The fees currently charged at the residential home range from £330.00 to £350.00 per week. Additional charges for hairdressing, podiatry services and toiletries are not included in the fees charged at the home. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 6.5 hour period and involved one inspector. As from the 18th September 2006 Ashton Court ceased to provide nursing care for service users at the home and is now providing residential care only. The community nursing team will now perform all nursing interventions at the home. Service users who were in residency prior to 18th September 2006 and required nursing interventions were relocated to alternative nursing homes. The remaining service users at Ashton Court were assessed as needing residential care only. The acting manager at Ashton Court had previously been employed at a sister home within Hearn Care Homes Ltd group. Following the closure of the sister home the acting manager transferred to Ashton Court Care Home on the 9th October 2006 to take the vacant acting managers post. Service users at the sister home were given the opportunity to relocate to Ashton Care Home following the closure of the sister home. The main method of inspection was case tracking. This is a method of randomly selecting service users and discussing with them their expectations and experiences within the home, together with the care practices utilised within the home environment. The case tracking method also examines the records of the service users to ascertain if the service users identified needs are being addressed appropriately and that their safety and well-being is being maintained. Also as part of the inspection process the acting manager and a staff member were informally interviewed to further evidence the quality of care afforded to the service users. A range of additional information was used to determine the outcome of this inspection and the report. These included the previous judgments and findings, information received from service users in response to the Commission for Social Care Inspection questionnaires, and the pre-inspection information provided by the registered provider in August 2006 What the service does well: All service users said that they felt safe within Ashton Court Care Home. Service users paid particular praise to the staff and management employed at the home, saying they are friendly and efficient. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 6 Although the acting manager at Aston Court Care Home has only been in post for a short period of time she could evidence to the inspector that she has clear aims and objectives for the development of the residential facilities at the home. The service users spoken with said they were afforded appropriate levels of privacy, respect and dignity at the home at all times. What has improved since the last inspection? What they could do better: The gas appliances at Ashton Court Care Home will require inspection by an approved gas installation engineer as a matter of priority as the last inspection of the gas appliances at Ashton Court Care Home was performed on 11th January 2002. Shortfalls were identified in relation to staff training that could compromise the safety of service users at the home. Due to the recent relocation of service users from the sister home two differing evaluation and care planning documentation formats were evident, which could compromise the safety of service users at the home. Currently the home does not provide enough stimulating social activities for the service users at the home. A selection of meal options was not displayed on a daily basis which compromises the service users ability choose from a varied menu. The reason for omission of medication codes was not being used correctly as gaps were present on one case tracked service users Medication Administration Records (MAR). The facility for reporting complaints and concerns to the manager at the home is currently ineffective and will require revision to ensure a robust complaints system is established. The acting manager at Ashton Court is not registered with the Commission for Social Care inspection (CSCI). Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 7 The service users consultation process is currently ineffective at the home, which could compromise the service users ability to fully participate in any developments within the home. Procedures had not been fully adhered to in relation to the management of service users money. 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. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 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 Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 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): 3. 6. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Assessment documentation is completed effectively to ensure the home can meet the individual residential needs of the service users. The home does not provide intermediate care services. EVIDENCE: The acting manager had only been in post for one week at the time of the inspection. The acting manager was in the process of transferring information from the previous nursing assessment documentation utilised at the home, to assessment documentation designed to identify and meet the residential needs of the service users at Ashton Court. The acting manager evidenced to the inspector the needs assessment documentation to be utilised at the home for all service users. The documentation was found to be effective in identifying the holistic needs of the service users and included the service users health needs, personal needs Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 10 and social care needs. The assessment documentation also utilises information from social service assessments when available. In ensuring continuity of care at the home and effective access to information pertinent to the service users needs the registered person should ensure that all service users assessment documentation is available in one format by 25th November 2006. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 11 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users health, personal and social care needs are set out in individual care plans to ensure health care needs are fully met. The current practices in relation to the administration of medicines at the home could compromise the safety of service users. Service users are afforded appropriate levels of privacy, respect and dignity at the home EVIDENCE: As with the needs assessment documentation, the acting manager was in the process of transferring information from the previous care planning documentation utilised at the home to the residential care planning documentation. The inspector examined the care planning documentation. The care plans included the service users individual profile, ‘Manual Handling Assessment’ and ‘Client Capabilities assessment. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 12 The care planning documentation was reviewed on a monthly basis and risk assessment documentation was re-evaluated on a 6 monthly basis to ensure the changing needs of the service users are identified and addressed effectively by staff at the home. Service users signatures were seen on care plan review sheets thus evidencing that service users had given consent to the content of the care plans. A service user spoken with also confirmed that she had seen her care plan and agreed to the content. The service users also confirmed that the care plans are reviewed monthly. A senior carer spoken with on the day of the inspection said that the changing needs of the service users are discussed at handover or with the manager and that care plans are amended to address all the identified needs of the service users. As with the needs assessment documentation the registered person should ensure that all service users care planning documentation is available in one format by 25th November 2006 to ensure continuity of care at the home. The service users spoken with were happy for the staff at the home to administer their medication stating, “The staff sort all my tablets out and that’s fine. I always get my tablets on time” and “staff give me my medication and I am happy with the arrangement”. Currently two types of medication delivery systems are in operation at the home in the forms of a cassette (NOMAD) system and a Monitored Dosage System (MDS). The acting manager stated that the MDS system will be instigated for all service users at the home and once the MDS system has been initiated all the senior carers will receive training or refresher education in the delivery of medicines. The case tracked service users Medication Administration Record (MAR) were examined. It was established that policies in relation to the administration of medicines had not been fully adhered to for one service user. The reason for omission of medication codes was not being used correctly as gaps were present on the residents MAR charts with no explanation as to why the medication had not been given. The inspector discussed the gaps in the MAR charts with the acting manager. It was agreed that all staff responsible for the administration of medicines at the home will be informed of the shortfall and the reason for omission code will be used effectively in the future, thus promoting the safety of service users at the home. To effectively address the aforementioned concern, the registered person is required to ensure that polices and procedures in relation to the receipt, storage, administration and disposal of medicine are followed and that staff receive training appertaining to the management of medicines. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 13 The acting manager stated that the staff at the home are always encouraged to promote respect and independence of the service users. The acting manager and senior care highlighted the importance of staff knocking on the service users bedroom doors prior to entering and ensuring personal care takes place in bathrooms or the service users bedrooms, ensuring that doors are closed and curtains are drawn. The “Have Your Say” Survey asked service users “ Do the carers listen and act on what you say”, 100 of the respondents stated yes. All the service users spoken with on the day of the inspection were very complimentary about the way staff spoke to them and attended to their needs. Service users confirmed that staff always knocked on the resident’s bedrooms doors before entering and also stated that staff always promote privacy and dignity when bathing or performing personal care. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The social activities provision at the home will require revision to ensure that service users expectations and preferences in relation to their social, cultural, religious and recreational interests are met. Service users are encouraged to maintain contact with their family, friends and the local community. Service users choice is respected at the home and service users have control over their lives. Service users are provided with a wholesome, appealing and balanced diet but the service users ability to choose from a varied menu is compromised. EVIDENCE: The “Have Your Say” Survey asked service users “ Are there activities arranged in the home that you can take part in”. Only 7 of the respondents stated yes, 35 of the respondents said usually, 28 of the respondents said sometimes and 7 of the respondents said never. A service user who had been in residency for approximately four weeks, said that she had never seen any social activities being performed at the home, Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 15 although she stated that she spends every afternoon in her room watching television or reading, as this is her preference. Another service user who had been in residency for several years stated that she had been out to the local shopping centre with her family and friends and also confirmed that the home has had guest entertainers in the past but “nothing much seems to be happening now”. The acting manager evidenced that two Social Activities Coordinators are currently employed at the home although one activities coordinator had been off sick. An examination of the staffing rota evidenced that both Social Activities Coordinators are employed for seven hours per week one on Wednesday afternoons and one on Thursday afternoons. The acting manager also stated that it is planned that Tuesday and Friday afternoons will be designated music afternoons and entertainers have been arranged for these times. The manager also stated that more board games would be made available to provide a stimulating environment for service users. The registered person should ensure that the service users are able to participate in stimulating daily activities and that all service users are made aware of forthcoming social events and provided with organised trips beyond the homes immediate environment. The acing manager and senior carer said that the home operates an open door policy in which service users relatives and friends can visit whenever they wish. Service users spoken with also confirmed the open door policy and said that the staff at the home are friendly and accommodating. Service users also said that they are helped to be part of the local community and enjoy trips to the local town centre of Eastwood whilst being accompanied by care staff from the home or with friends and relatives. The acting manager said that service users are encouraged to make independent decisions and the staff at the home always respect the service users choices. Service users said that they could spend the days as they please, either in their rooms, watching television and reading or socialising with other service users in the communal areas at the home. The “Have Your Say” Survey asked service users “ Do you like the meals at the home”? 35 of the respondents stated yes, and 65 of the respondents said usually. A service user spoken with stated, “the food is very good but the staff do not usually ask us what we would like to eat”. The service user said she had not seen a lunchtime menu although some choice is given at breakfast, and the teatime food is great. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 16 Another service user stated, “the food is OK, I always get what I want but a choice is not made available”. The inspector examined the menu board displayed in the dining area at the home. The menu gave the impression that the meal provision on the day of the inspection was a choice between, Cornish pasties, fish pie, mixed grill or fish fingers followed by ice cream. Following a discussion with the cook at the home the inspector established that the menu was only an example of what could be provided at the home and the actual menu on the day of the inspection was a Gammon dinner followed by ice cream or Bakewell Tart. The acting manager confirmed a that choice of meal provision is not currently displayed. The acting manger went on the say that it is planned that in conjunction with the cook at the home and the service users, a new menu will be formulated and the new menu will be displayed for the service users perusal. To registered person should ensure that service users are offered a choice of meals in written or other formats to suit the capacities of all service users, which is given, read or explained to service users. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 17 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, 18. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users feel that any concerns or complaints will be listened to, taken seriously and acted upon by the acting manager and staff at the home. Not all staff at the home has received appropriate training in relation to the protection of the vulnerable adult, which could compromise the safety of service users at the home. EVIDENCE: At the time of the inspection the acting manager was not investigating any complaints and the Commission for Social Care Inspection had not received any complaints appertaining to the service provision at the home. The “Have Your Say” Survey asked service users “ Do you know how to make a complaint”. 65 of the respondents stated yes, and 35 of the respondents said usually. Two service users spoken with said that they have never had cause to complain about the care provided at the home but went on to say that they were not aware of the complaints procedure displayed in the foyer of the home. Another service users said “I have no major concerns about the home and have not had cause to make a complaint but if I did I would see the acting manager, as she is efficient and would sort it out for me”. A senior carer stated that she takes all complaints seriously. The senior carer said that should she receive a complaint she would document the elements of the complaint, ensure the safety of the service users and liaise with the acting manager to ensure the complaint was resolved effectively. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 18 Evidence gained from a previous inspection established that the previous manager had initiated an effective complaints and concerns reporting procedure. Previously, complaint documentation was available in the reception area, which could be filled out and passed onto the manager in a sealed envelope thus respecting confidentiality for the service users and their relatives whilst promoting an effective communication process. The acting manager at the home stated that a similar system would be introduced. Complaint forms will be made available once again; in the foyer of the home so as to ensure that service users and their representatives have an effective resource for reporting concerns and complaints. To address the aforementioned shortfalls, the registered person should establish an effective complaints system is established. The complaints system should ensure that all service users and their representatives can report any concerns and complaints to the manager of the home and that all service users at the home are aware of the complaints procedure. The “Have Your Say” Survey asked service users “ Do you know who to speak to if you are not happy. 85 of the respondents stated yes, 7 of the respondents said usually and 7 of the respondents said sometimes. All service users spoken with on the day of the inspection said that they felt safe within the homes environment. A senior carer, who had been in employment at the home for approximately four weeks stated that she has recently completed a protection of vulnerable adults course provided by a previous employer. The carer stated that if she suspected abuse was happening in the home she would firstly ensure that service users are safe, ensure that all incidents are documented and reported to the acting manager at the home. The senior carer also stated that she would consider contacting the Commission for Social Care Inspection, Social Services or the police if she felt it necessary. The acting manager was able to evidence that all the staff who had moved over to Ashton Court from the sister home had received training appertaining to the protection of the vulnerable adult. An examination of the staff training records supplied by the previous manager at the home did not evidence that pre-existing care staff at the home had received mandatory training in relation to the protection of the vulnerable adult. The acting manager stated that it is her intention to analyse all the staff training documentation thus determining the training needs of the entire workforce at the home so that appropriate training opportunities can be provided. To protect the safety of the service users, the registered person should ensure that all staff at Ashton Court receives appropriate training appertaining to the protection of the vulnerable adult. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 19 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, 26. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Ashton Court provides an environment that is safe and well maintained. Ashton Court provides an environment that is clean, pleasant and hygienic. EVIDENCE: Ashton Court has benefited from a recently completed refurbishment programme and now provides a safe and well-maintained environment for service users. In ensuring that the homes environment continues to be safe the manager stated that it is her intention to initiate monthly environmental audits. The intention of the audit would be to ensure that all areas within the home are maintained to a good standard of repair and décor throughout. The “Have Your Say” Survey asked service users “ is the home fresh and clean”. 85 of the respondents stated yes, 7 of the respondents said usually and 7 of the respondents said sometimes. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 20 The inspector performed a partial internal inspection of the home, which included the case tracked service users bedrooms and the communal areas they frequent. The case tracked residents bedrooms were found to be personalised, homely and safe. All communal areas were well decorated and free of obstacles. The communal toilets were maintained to a high standard and the home was odour free throughout. All service users spoken with said that they were satisfied with their bedrooms and the overall standard of hygiene within the home. A service user said that “the home is lovely and clean, my room is cleaned daily as is all the home”. Another service users stated, “Overall the home is exceptionally clean”. The home also benefits from a newly constructed conservatory area in which furniture is available for the residents and their visitors to enjoy. On the day of the inspection several service users were sitting in the conservatory area. The conservatory felt cold and it was established that the area did not have any form of heating or cooling provision. To ensure the safety of service users the registered person is required to ensure that ventilation, heating and lighting suitable for service users is provided in all parts of the care home, which are used by service users. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 21 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, 28, 29, 30. Quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are met by the numbers and skill mix of staff at the home. Service users stated that they feel they are in safe hands at all times. The inspector could not fully assess that the service users are protected by the recruitment policies and procedures utilised at the home. Staff at the home requires further mandatory training to ensure the service users at the home are safe. EVIDENCE: The “Have Your Say” Survey asked service users “ Is staff available when you needs them? 58 of the respondents stated yes, 42 of the respondents said usually. Service users spoken with stated “ the staff numbers are fine” and “it always appears to be lots of staff in the home and they attend to the needs of the service users at the home without problems”. On the day of the inspection 26 service users were in residence at the home. An examination of the staffing rota evidenced that throughout the day the home was staffed by one senior carer plus three carers and throughout the night the home is staffed by two carers. A senior carer stated that the staffing levels do meet the needs of the service users but staff have little time to spare to just talk to the service users. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 22 The inspector could not fully evidence that policies and procedures in relation to the recruitment of staff at the home had been adhered to. The recruitment files of the last two members of staff to be employed at the home were not available for inspection. Two alternative staff files were examined on the day of the inspection and were found to be satisfactory as they contained Criminal Records Bureau Checks (CRB), documentary proof of identity and two satisfactory references. The registered person shall ensure that records are at all times available for inspection in the care home by any person authorised by the Commission for Social Care Inspection to enter and inspect the care home Service users spoken with said that they felt safe in the home and the staff are well trained and competent in their duties. An examination of the staff-training matrix evidenced that several staff have not attended mandatory training in Health and Safety, Moving and Handling, Infection Control, Protection of the Vulnerable Adults and Food Hygiene. The ensure the safety of service users at the home, the registered person will be required to analyse all the staff training documentation to determine the training needs of the entire workforce at the home so that appropriate training opportunities can be provided. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 23 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, 38. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users were not benefiting from the home having a registered manager although the Acting Manager displayed competence. An effective consultation process is not performed at the home and the service users ability to contribute to developments in the home is compromised. The home a robust system is in place to ensure that service users financial interests are safeguarded but the system has not been fully adhered to. The health and safety of service users is promoted and protected at the home. EVIDENCE: As mentioned earlier in the report the acting manager had previously been employed as the acting manager at the sister home, which is part of Hearn Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 24 Care Homes Ltd. Following the closure of the sister home the acting manager transferred to Ashton Court Care Home on the 9th October 2006. The acting manager is currently in the process of familiarising herself with Ashton Court Care home and it was clear that the acting manager had defined goals to achieve to ensure the residential care provision at Ashton Court is of a high standard. As mentioned earlier in the report the acing manager stated that her priority would be to ensure that all the service users evaluation and care planning documentation is in one format to ease the communication process. It is also the intention of the acting manager to examine the training opportunities provided to staff at the home so as to identify any shortfalls and address the shortfalls with appropriate training provision. The acting Manager said she had recently gained a Registered Managers Award and is awaiting her certification. It is the intention of the acting manger to apply for registration with the Commission for Social Care Inspection as the manager at Ashton Court but as yet CSCI have not received an application. A service user spoken with stated, “the acting manager is excellent, always approachable and friendly and I feel that she would handle any concerns effectively”. The senior carer said that she had confidence in the manager’s abilities saying that she is efficient, approachable and solves problems effectively. The service users spoken with stated that were not aware of any service users meetings being performed in the home. The acting manager also confirmed that the home does not have effective consultation practices as yet but it is her intention to initiate an effective service user consultation process at the home in the near future. The manager stated that it is her preference to perform one to one conversations with service users rather than collective service user meetings as it provides the service users the opportunity to express any issues of concern in private. In ensuring that Ashton Court Residential Home is run in the best interests of the service users the registered person should ensure that an effective consultation process is initiated at the home so as to provide a forum for service users to discuss all aspects of care provision at the home. The Homes records appertaining to the financial management of service users personal money were seen and balances were ‘cross-checked’ against the contents of individual wallets for a case tracked service users. A case tracked service users recorded balance was £14.50 but the actual amount in the service users individual wallet was £4.50. In highlighting the deficit, the acting manager checked the service users resent transactions and it was evidenced that money for hairdressing services and podiatry services had Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 25 not been taken of to running total, once the deductions had been made the service users money did correlate with the recorded figure. The ensure the service users finances are safeguarded the registered person should ensure that all service users monetary records are maintained accurately and that balance checks are made at each transaction. In determining that the health and safety of service users is protected the inspector examined a range of Health and Safety information provided within the pre-inspection questionnaire. The information evidenced the following, Safety training (28th June 2006), fire equipment checks (28th June 2006), emergency lighting checks (22nd May 2006) and hoist and adaptation checks (25th July 2006). The pre inspection questionnaire evidenced that an approved gas installation engineer had last inspected the gas appliances at Ashton Court Care Home on 11th January 2002. To ensure the safety of service users at the home is maintained, the registered person will ensure that competent persons (eg members of Council of Registered Gas Installers (CORGI) undertake regular servicing of boilers and central heating systems at Ashton Court. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 26 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 27 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. 1 Standard OP7 Regulation 18 (C) (1) Timescale for action The registered person will ensure 31/03/07 that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. The registered person will ensure 25/11/06 that competent persons undertake regular servicing of boilers and central heating systems at Ashton Court to ensure the safety of service users is maintained. Requirement 2 OP38 13 (4) (a) 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 OP3 Good Practice Recommendations The registered person should ensure that all service users evaluation documentation is available in the one format by 25th November 2006 to ensure continuity of care at the home. The registered person should ensure that all service users care planning documentation is available in one format by 25th November 2006 to ensure continuity of care at the home. DS0000063149.V314452.R01.S.doc Version 5.2 Page 28 2 OP7 Ashton Court Care Home 3 OP9 4 OP12 5 OP15 6 OP16 7 OP19 8 OP19 9 10 OP31 OP33 11 OP35 The registered person should ensure that reason for the omission of medication codes are used correctly and no gaps are present on the service users Medication Administration Records. The registered person should ensure that the service users are able to participate in stimulating daily activities and that all service users are made aware of forthcoming social events and provided with organised trips beyond the homes immediate environment. To registered person should ensure that service users are offered a choice of meals in written or other formats to suit the capacities of all service users, which is given, read or explained to service users. The registered person should establish an effective system is in place to ensure that all service users and their representatives can report any concerns and complaints to the acting manager of the home and that all service users at the home are aware of the complaints procedure. The registered person should ensure that ventilation, heating and lighting suitable for service users is provided in all parts of the care home, which are used by service users. The registered person should ensure that records are at all times available for inspection in the care home by any person authorised by the Commission for Social Care Inspection to enter and inspect the care home. The Registered Person should ensure that a manager is registered with CSCI who is qualified, competent and experienced to run the home. The registered person should ensure that an effective consultation process is initiated at the home so as to provide a forum for service users to discuss all aspects of care provision at the home. The registered person should ensure that all service users monetary records are maintained appropriately and that balance checks are made at each transaction. Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Ashton Court Care Home DS0000063149.V314452.R01.S.doc Version 5.2 Page 30 - 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. 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