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Inspection on 16/06/05 for Ashton Grange Residential Home

Also see our care home review for Ashton Grange Residential Home for more information

This inspection was carried out on 16th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

In the 22 residents/relatives comment cards, which were returned prior to the inspection all but one, stated that they had never had to make a complaint and the one person who did make a complaint stated that the manager acted it upon immediately. The complaints process is widely promoted in the home and the manager welcomes any comments, concerns or complaints about the service being provided. Some of the written comments made were, " My mother is well looked after and in a safe environment" " I would like to thank all concerned, I find my brother really happy and well cared for" "Most of the time there are sufficient staff on duty but occasionally they can be a bit stretched". The manager has a positive commitment towards staff training and this has ensured that staff have had opportunities to develop their individual knowledge and skills. In addition to this the manager has worked hard to recruit new staff and develop a staff team that are professional in their work and who also share the same values as the organisation. Observations made confirmed that staff are professional in their approach with residents whilst at the same time able to share a laugh and a joke and this contributed to the positive atmosphere. Residents stated that this is a "nice home" and "they like living here". The manager is developing forums whereby residents can actively contribute their views about the service and this has led to positive developments in the home. A recent written survey carried out by the manager with residents and their families resulted in a number of questionnaires being returned and the manager will be using these as a guide to future developments within the home.

What has improved since the last inspection?

The food services and meals in the home are much improved and the residents confirmed this during discussion. How the food is served and the choice of meals available is better and the dining rooms, which have been refurbished, offer a nice room to eat in. The premises are much improved as result of the refurbishment programme and care and consideration has gone into the colour scheme to make sure all areas of the home are light and well lit. Residents have been involved in choosing colours and this has resulted in them choosing the colour of their bedroom door. Lighting has been improved in all bedrooms and new shades and furniture have been provided throughout the home including resident`s bedrooms. Staff training has continued to be developed and this is ongoing and positive steps have been made to recruit staff into vacant positions. Observations made confirmed that staff practices while carrying out their work was much improved and in discussion with staff they were able to demonstrate that they had a good understanding of individual residents needs and what help they would require.

What the care home could do better:

The manager is aware following discussion how care plans must continue to be developed in order to demonstrate how staff are meeting individual residents health and social needs. Active steps are being taken by the manager to recruit a person to carry out the role of activities coordinator and the manager is aware of how activities for the residents need to be developed. The manager should continue to develop the individual activity record for residents so that she confirm how individual interests and activities are included in the level of activities to be provided. The manager needs to ensure that as part of the assessment process for prospective service users that written confirmation is issued to each service user or their representative confirming that their needs can be met in the home.

CARE HOMES FOR OLDER PEOPLE Ashton Grange Residential Home St Lukes Road Pallion Sunderland SR4 6QU Lead Inspector Clifford Renwick Announced Thursday 16 June 2005 & 8 July 2005 th th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashton Grange Residential Home Address St Lukes Road Pallion Sunderland SR4 6QU 0191 567 4003 0191 565 2303 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Highfield Care Homes No 3 Ltd Miss Allison Elaine Smith Care Home only 40 Category(ies) of OP Old age (40) registration, with number DE(E) Dementia - over 65 (13) of places PD(E) Physical dis - over 65 (10) MD(E) Mental Disorder -over 65 (9) PD Physical disability (3) Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 & 18 January 2005 Brief Description of the Service: Ashton Grange provides personal care to 40 older people over the age of 65 years and some of who may have dementia or mental health needs. It provides personal care only and any health needs are dealt with by the Community Nursing Services.It is also registered to provide care for a maximum of 10 people with a physical disability.The home is purpose built and approximately 6 years old and is located in what can be described as the “heart” of the Pallion community. The building is of brick construction and 2 storey offering accommodation on both floors. It has its own drive and parking area and an enclosed garden. All areas are accessible to people who may be dependent upon the use of a wheelchair.It is adjacent to the local church and community centre and it is only a short walk to a busy shopping parade, which has a range of facilities.It is on a bus route offering easy access to the city centre as well as the surrounding areas. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 2 working days and was carried out as part of the statutory twice-yearly inspection process. The inspection was announced and prior to the inspection the commission received 22 surveys/comment cards from residents and their families, which offered comments on the service being provided. These confirmed that they had no complaints and were satisfied with the services that were offered in the home. All areas of the premises, which included communal areas and bedrooms, were viewed. Care records were examined as well as records that related to health and safety and social activities and examination of records of new staff employed in the home was also carried out. Discussion took place with the staff on duty throughout the visits. Discussion also took place with 10 service users and three relatives and time was spent observing staff practices and how staff spoke to residents. It was established in discussion that the people who live in this home preferred to be known as residents therefore this term of reference is used throughout the report. The judgements made are based on the evidence available at the time of the inspection. What the service does well: In the 22 residents/relatives comment cards, which were returned prior to the inspection all but one, stated that they had never had to make a complaint and the one person who did make a complaint stated that the manager acted it upon immediately. The complaints process is widely promoted in the home and the manager welcomes any comments, concerns or complaints about the service being provided. Some of the written comments made were, “ My mother is well looked after and in a safe environment” Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 6 “ I would like to thank all concerned, I find my brother really happy and well cared for” “Most of the time there are sufficient staff on duty but occasionally they can be a bit stretched”. The manager has a positive commitment towards staff training and this has ensured that staff have had opportunities to develop their individual knowledge and skills. In addition to this the manager has worked hard to recruit new staff and develop a staff team that are professional in their work and who also share the same values as the organisation. Observations made confirmed that staff are professional in their approach with residents whilst at the same time able to share a laugh and a joke and this contributed to the positive atmosphere. Residents stated that this is a “nice home” and “they like living here”. The manager is developing forums whereby residents can actively contribute their views about the service and this has led to positive developments in the home. A recent written survey carried out by the manager with residents and their families resulted in a number of questionnaires being returned and the manager will be using these as a guide to future developments within the home. What has improved since the last inspection? The food services and meals in the home are much improved and the residents confirmed this during discussion. How the food is served and the choice of meals available is better and the dining rooms, which have been refurbished, offer a nice room to eat in. The premises are much improved as result of the refurbishment programme and care and consideration has gone into the colour scheme to make sure all areas of the home are light and well lit. Residents have been involved in choosing colours and this has resulted in them choosing the colour of their bedroom door. Lighting has been improved in all bedrooms and new shades and furniture have been provided throughout the home including resident’s bedrooms. Staff training has continued to be developed and this is ongoing and positive steps have been made to recruit staff into vacant positions. Observations made confirmed that staff practices while carrying out their work was much improved and in discussion with staff they were able to demonstrate that they had a good understanding of individual residents needs and what help they would require. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 7 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. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 A range of information is available which enables prospective residents to make a fully informed choice about where they would like to live. Each resident is issued with either a contract or a statement of the terms and conditions of residence, which confirm what services, will be provided in the home. Positive practices are in place which ensure that no one moves into the home until an assessment of needs has taken place however the home needs to confirm in writing that peoples needs can be met in the home. The home does not provide intermediate care. EVIDENCE: There are two kinds of contracts used by the organisation depending on how the placement is funded. For those residents who are privately funded they are issued with a contract, which is informative and clearly lists what is provided in the fee and what additional items have to be paid for. For those residents who are funded by the Local Authority they are issued with the Homes Statement of Purpose and Service User guide which contains the terms and conditions of residence. This is not as extensive as the contract issued to residents who are Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 10 privately funded though information relating to the terms and conditions are also covered separately in the Statement of Purpose and Service User Guide. Discussion with the manager confirmed that there is also a contract issued by the Local Authority known as the IPA and these are used for all service users who are funded by the Local Authority. Discussion held with the manager confirmed that all prospective service users are issued with a copy of the homes Statement of Purpose and Service User Guide and before any admission is agreed a full and comprehensive assessment is carried out in order to ensure that individual resident needs can be met in the home. Examination of residents case files confirmed this to be correct, however the home are not confirming in writing to prospective service users that their needs can be met on the basis of the assessment, which has been completed. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 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 standard(s) 7, 8 Residents care plans are in place, but these do not fully record their observed needs or the level of support that is offered by staff. This can limit the guidance available regarding care practice and consistency. The Health and personal care needs of residents based on examination of their care plans and daily records confirm that they are receiving appropriate health care from other professionals. EVIDENCE: Each resident has an individual care plan, which sets out how their individual assessed needs are to be met. Examination of case files and observations of staff practices confirmed that the written care plans do not always reflect in sufficient detail some of the positive practices that are being carried out by staff. For one resident who requires staff to communicate in a specific way in order to be effective this does take place but is not reflected in the care plan. Discussion held with the manager confirmed that she is in the process of developing the care plans with senior staff and that this is reviewed on a monthly basis. Discussion also took place about the need to ensure that when Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 12 evaluating the care plans on a monthly basis the written evaluations should include any progress that has been made or whether care needs remain the same. The manager was aware that as part of the ongoing developments of the care plans that staff needed to include information relating to social needs and how these would be addressed. The manager is enthusiastic about the ongoing developments and in discussion she explained how senior staff were continuing to develop their skills in this area of work to ensure that the level of care offered has positive outcomes for service users. Each resident has on display in their room a photograph of their key worker and these assists in informing them who is responsible for supporting them on an individual basis with personal care tasks. As part of the ongoing development of the care plans steps have also been taken to build up a personal history of service users and this has included information about the type of house they used to live in. As a result of this residents have chosen which colour they would like their bedroom door to be painted and also what they would like to have on their door. This has had positive benefits for those service users who have dementia type illnesses and assists them in identifying their bedroom. Comprehensive records are available in case files, which confirmed that all aspects of resident’s health needs, are being met. The manager is a good advocate on behalf of residents and recently had cause to raise concerns with the local hospital following the care they offered to a resident from the home. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 15 Arrangements to provide activities and occupation are underdeveloped within the home. The development of a planned, structured and well delivered activities programme can contribute to a more interesting and stimulating lifestyle for service users. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This can contribute to their general health and wellbeing. EVIDENCE: Discussion with the manager confirmed that at present the level of activities provided for residents are not as good and varied as she would like them to be due to being unable to recruit for the vacant activities coordinators post. Activities currently provided include the hairdresser, trips out to the local shops with staff, chair aerobic exercises and for some residents a trip out to the local “natter” club in the community. Discussion with residents confirmed that bingo is still provided for those who request it and the prizes now on offer are much improved. The manager confirmed that she is developing a weekly activity board following discussion with residents about the type of activities that they would like provided in the home. Discussion was held with the manager about the role of staff and how as part of their development they could compile a more comprehensive social history in the care plan to assist with identifying Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 14 individual interests and activities of residents. The manager also confirmed that she is in the process of developing a newsletter, which could be issued to residents and families to make them aware of what was happening in the home and what developments were being considered. Lunch was taken with residents who reside on the first floor on the first day of the inspection and on the ground floor on the second inspection visit. Both occasions were enjoyable with food being well presented, sufficient in quantity, hot and very tasty. Tables were nicely set and menus were available on the table, which showed the main meals and also the alternative choices available. Suppers are now included as part of the menu and this enables residents to see what choices are available for this meal. One night per week (Wednesday) residents have a takeaway meal, which is normally fish and chips. Ten staff have received training in food hygiene and there is an ongoing training programme for staff in food awareness, food serving and customer care and this has had positive benefits for staff as the meals service is much improved. Staff were observed to offer assistance to those residents who required support to eat their meal and this was done in a personal an unhurried manner making the process of eating an enjoyable occasion. Special diets are available for those residents who require them and soft diets were available for a person who had recently had new dentures fitted. Discussions held with service users confirmed that they were satisfied with the meals in the home and they stated that there was always plenty to eat. They also stated that the supper menu was much improved with a wide choice of snacks and drinks available to choose from. A number of residents stated that what they liked about the food was that it was “good old plain home cooking” and that there was always plenty. Some residents also commented upon the fact that the chips are always home made and that these were much preferable to the frozen types. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints in the home are handled objectively and openly with the manager and staff encouraging residents, their friends and families to offer comment on the services that are offered. Residents are confident that any complaints made would be acted upon. EVIDENCE: A copy of the homes complaints process is on display in the lobby and every resident has a copy of the homes complaints process included with the Statement of Purpose in their bedroom. Records of any complaints made are kept and examination of the records confirmed that the manager takes a positive approach in dealing with any complaints brought to her attention. The complaints records varied in the level of information that was included and discussion was held with the manager about additional information that should be included. Discussion held with both residents and their families confirmed that they had no complaints about the service but if they did they would feel comfortable about raising them with the manager or the staff. Similarly from the 22 surveys issued by the commission and received from families and residents prior to the inspection people clearly stated that they were aware of the homes complaints process. One person stated that they had made a complaint and this had been addressed quickly and to their satisfaction with improvements being made as a result of complaining. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25, 26 The home is clean, well decorated and maintained. This can help promote a positive image for service users, and ensure they remain safe. Some lounge chairs are worn and need to be replaced, as they do not promote good hygiene. EVIDENCE: All areas of the home were viewed over the 2 days of the inspection. At the time of the visit a refurbishment programme had commenced and this has resulted in laminated flooring being fitted to both dining rooms and the removal of sink units which were seldom used by residents. Corridors were in the process of being decorated and new carpets have been fitted. Several bedrooms have been decorated and new bedroom furniture has been provided for all residents with the exception of those residents who have brought their own furniture into the home. The lighting in the bedroom has been increased with the fitting of stronger bulbs and new shades. The company employ a G.P who has a specific interest and experience in working with people who have Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 17 dementia type illnesses and this has resulted in advice being offered about colour schemes and design features to support residents with orientation around the building. As part of the refurbishment programme lounge chairs, which are now worn, are to be replaced and discussion with the manager confirmed that these have been ordered. Pictures and other items are also on order and will be fitted once the decoration is complete. A good standard of hygiene was evident throughout the building and there were noticeable safety hazards at the time of the inspection visits. Discussions held with both residents and their families confirmed that they were pleased with the changes to the building and they liked the option of being able to choose the colour of their bedroom door and whether they wished to have a photograph on the door or a favourite picture. The idea of having large numbers on the door in the style of what you would have on a front door was seen as a positive development as these provide a good visual aid to those service users who have a visual impairment. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 A well-trained staff team meets the resident’s needs. However, further training is required in the area of dementia in order to provide staff with an understanding of this illness so that they can adequately meet the needs of all of the residents living in the home. The procedures for the recruitment of staff are robust but should also include a signed health declaration by staff in order to ensure that they are physically and mentally fit for the work they are carrying out. EVIDENCE: Examination of staff duty rosters confirmed that agreed levels of staffing are being maintained in the home. Several staff have ceased to work in the home since the last inspection and four new staff have been recruited. The manager is still attempting to recruit a person to fill the activities coordinators role, which has been vacant since the beginning of the year. Case files for new staff were examined and this confirmed that all new staff had received induction training and had been allocated an experienced member of staff as a mentor to them when they commenced work in the home. All necessary documentation is obtained by the organisation as part of the recruitment process with the exception of a signed health declaration by staff. Prospective staff provides information about their health as part of the application for employment but this form needs to be expanded in order to ensure that all information as required by regulation is obtained. It was positive to note that the manager explores any gaps in employment as well as Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 19 any current or past illnesses as part of the recruitment process and a record is kept for future reference. Training is in place for all staff and senior staff have received training in care plans, safe handling of medication and dealing with complaints and enquiries. Training for other staff is ongoing with plans in place for all mandatory training to be completed as well staff having the opportunity to undergo specialist training in dementia care. There is a positive approach towards training by the manager and this has had benefits in developing individual staff practices. Observations made during the inspection visits confirmed that staff have a pleasant and professional approach to their work and there was a good rapport between them and the residents and also the resident’s families who were visiting at the time. Discussions held with staff indicated that they were aware of their own training needs and also how they would like to develop these and they discussed this in supervision with the manager. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36, 38 The manager offers clear leadership and direction to the staff so that they can consistently meet the needs of service users. Staff are appropriately supervised which assists in promoting and safeguarding the best interests of the resident’s. A well-managed staff team promotes the health and safety of the service users. EVIDENCE: The manager remains positive about the developments, which are continuing to take place in the home and is actively developing the role of the senior care workers by delegating individual tasks. The manager is open in her approach and has set personal standards within the home, which she expects all staff to work to. This at times has led to internal conflicts and disagreements but the manager has not allowed this to impact upon the residents. The manager has addressed each situation in a positive way, which has included staff meetings as well as individual supervisions and on some occasions has resulted in staff Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 21 ceasing to work in the home. The ongoing recruitment of staff in the home in which the manager has been fully involved with has had positive benefits in not only raising morale but with developing a staff team into a workforce which is positive and committed to the job that they are doing. The manager carries out 2 monthly supervision with all staff and this is used as the basis to set out personal development for staff as well as to reinforce the aims and objectives of the services to be provided to residents. The atmosphere throughout the visit was vibrant and staff were observed to be confident in what they were doing whilst at the same time maintaining a sense of humour in their rapport with service users. Residents spoke highly of the manager and the staff and it was clear from observations that some of the staff do more than is expected of them such as shopping in their own time for residents. Some residents commented on how the new staff had settled into the home quickly and also how nice they were. All staff have completed mandatory training, which has included fire training, and records held in the fire logbook confirmed that staff are receiving appropriate fire instruction and fire drill training. There were no health and safety issues identified during either of the inspection visits. Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x 3 x 3 Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4 Regulation 14 (1) (d) Requirement Written confirmation must be issued to service users/ and or their represprentatives confirming that on the basis of the assessment their needs can be met in the home. Individual care plans must continue to be developed as advised within this report. Activities which reflect residents interests must continue to be developed. Employees must sign a health declaration stating that they are mentally and physically fit for the purposes of the work.(Outstanding since 18.01.05) Timescale for action Immediate 2. 3. 4. 7 12 29 15 (2) 15 7, 9, 19 31.01.06 31.12.05 Immediate 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 Good Practice Recommendations Ashton Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 Grange Residential Home B52 B02 S15762 Ashton Grange V216863 160605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!