Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 17/01/08 for Ashton Grange Residential Home

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

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

What has improved since the last inspection?

All repairs to either the environment or equipment have been addressed since the last visit in August 2007. All extractor fans have been cleaned to ensure that they work correctly. And in some bedrooms new extractor fans have been fitted. This ensures that adequate ventilation is provided in the bedroom toilets. A programme of decoration is in place and resident`s rooms are being decorated. The manager confirmed that new mattresses are also being provided in bedrooms. The first floor has been decorated and fitted with a range of photographs of Old Sunderland and other tactile and visual signs to assist people with dementia in finding their way around the building. The building is in good order and standards of hygiene are much improved. A new manager has been appointed and is in the process of applying to be registered with the Commission. New staff are and have been recruited and the home is currently creating a senior management team. All staff have received updated fire training to ensure that they are aware of the homes fire procedures and what actions to take in the event of an emergency. Recent training has also been provided on the safe use of bed rails, moving and handling and food hygiene. Since the last visit staff confirmed that the company have put in place a range of training courses to assist them in carrying out their work. Staffing levels have improved and the manager who is not included on the staffing rota is supernumerary to the staff team.

What the care home could do better:

The manager must continue to develop the residents` written plan of care in order to demonstrate the work that staff are doing to support residents with their assessed needs. The assessment documents that are used to monitor any changes in individual need and also the "life history " document, must continue to be developed to ensure that care plans are kept up to date. The menus should be made available in a variety of formats. This should include a mixture of written and picture menus, which can be made available at the dining table. This will assist in informing residents of what is available on a daily basis and help them to make a positive choice of what they would like to eat. The manager has the appropriate application form from the Commission for registration. This must now be completed and submitted to the Commission to become the registered manager. The registration certificate must be made available in the home and displayed in a place where it can be seen.

CARE HOMES FOR OLDER PEOPLE Ashton Grange Residential Home St Lukes Road Pallion Sunderland SR4 6QU Lead Inspector Mr Clifford Renwick Key Unannounced Inspection 09:30 17th January & 19th February 2008 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 Grange Residential Home DS0000015762.V356003.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 Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton Grange Residential Home Address St Lukes Road Pallion Sunderland SR4 6QU 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) 0191 567 4003 0191 567 4690 ashtongrange@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Homes No 3 Limited Position Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (13), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (9), Old age, not falling within any other category (40), Physical disability (3), Physical disability over 65 years of age (10) Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two places within the PD category relate to current service users only. 28th August 2007 Date of last inspection Brief Description of the Service: Ashton Grange provides care to 40 older people over the age of 65 years 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 is located in the Pallion area of Sunderland. The building has two storeys, with accommodation provided on both floors. It has its own drive with parking area and a fully enclosed garden. All areas are accessible to people who use 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. Fees range from £361 - £447 per week. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • • • • • Information we have received since the last visits in August 2007. How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The provider in the annual quality assurance assessment (AQAA) submitted information to confirm what they are doing in the home. The Visit: An unannounced visit was made on the 18th January and an announced visit on 19th February 2008. During the visit we: • • • • • • • • Talked with people who use the service, 3 relatives of people using the service, staff and the new manager. Held discussion with the company’s Operations Manager. Observed life in the home. Looked at information about the people who use the service & how well their needs are met. Looked at other records, which must be kept. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe & comfortable. Checked what improvements had been made since the last visit. We told the manager what we had found. The people who reside in this home prefer to be known as “residents”; therefore this term of reference is used throughout the report. At the time of the visit there were 25 people living in the home. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 6 What the service does well: The company have taken a positive approach to improving services in the home and have addressed most of the shortfalls in the operation of the service identified in the last inspection report. Staff receive structured training that is relevant to their work. Improved systems of accounting and how resident’s money is managed are good and regular audits ensure that residents are not placed at risk. The home provides a good range of meals that include a range of traditional meals and also what residents describe as continental meals. Staff morale is high and there is a good atmosphere among the staff team. One resident who is living in the home on a temporary basis said, • “Its great here, the girls are lovely and I would not mind moving in full time”. Other comments made by residents and relatives were, • • • “The staff are good they work really hard to look after the residents”. “The new manager has settled in well and he is making positive changes in the home”. “The manager is approachable and you can discuss anything with him” What has improved since the last inspection? All repairs to either the environment or equipment have been addressed since the last visit in August 2007. All extractor fans have been cleaned to ensure that they work correctly. And in some bedrooms new extractor fans have been fitted. This ensures that adequate ventilation is provided in the bedroom toilets. A programme of decoration is in place and resident’s rooms are being decorated. The manager confirmed that new mattresses are also being provided in bedrooms. The first floor has been decorated and fitted with a range of photographs of Old Sunderland and other tactile and visual signs to assist people with dementia in finding their way around the building. The building is in good order and standards of hygiene are much improved. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 7 A new manager has been appointed and is in the process of applying to be registered with the Commission. New staff are and have been recruited and the home is currently creating a senior management team. All staff have received updated fire training to ensure that they are aware of the homes fire procedures and what actions to take in the event of an emergency. Recent training has also been provided on the safe use of bed rails, moving and handling and food hygiene. Since the last visit staff confirmed that the company have put in place a range of training courses to assist them in carrying out their work. Staffing levels have improved and the manager who is not included on the staffing rota is supernumerary to the staff team. 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. The summary of this inspection report can be made available in other formats on request. Ashton Grange Residential Home DS0000015762.V356003.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 Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service. Residents’ needs are assessed before they move into the home which ensures that the home is an appropriate place to provide the care that they need. EVIDENCE: Care records showed that a full assessment was carried out before people moved into the home. A comprehensive assessment is provided from social services. These detail the level of support people will need and any existing health problems. The home uses this information to decide that they are able to provide the correct level of care to the person. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 10 Prior to admission prospective residents and their relatives are invited to visit the home to have a look around and ask any questions about the services provided. Staff use these visits to gain further information from the resident and their relative/representative so that they can complete their own assessment document. Though the home does not provide intermediate care, they continue to provide short breaks for older people who have had to move out of their house while the council carry out essential modernisation works. At the time of our visit there were two people using this service. One of these people expressed their satisfaction with the home and said they were very happy here and could not fault the service. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. We have made this judgment using a range of evidence, including a visit to this service. Health and social care needs are being met, for example, suitable medication procedures are in place that ensure residents receive their prescribed medicines and therefore their health and welfare is promoted. However more information needs to be recorded in the residents written care plan to confirm the actions carried out by staff to demonstrate how they support residents with their assessed needs. Good staff practices ensure that residents’ rights to privacy are respected. EVIDENCE: Care records contain admission information, pre admission assessments, physical assessments, and mental state examinations. These also include weight and nutritional assessments, assessments of pressure sore risk Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 12 (sometimes called bed sores), falls risk, and moving and handling assessments. A range of other information that is used to demonstrate how staff are supporting residents with their care needs is also included in the care file. Residents have good access to health professionals. Advice has been sought by staff from health professionals on dealing with pressure care and mobility. The care files are much improved in their layout making them easier to read and also to find information about how individual residents needs have been assessed. Files are laid out in sections with index cards and enable you to follow the assessment process from admission to the current day. Information that is included in the file confirms how residents wish to be addressed, their preferences about how they spend their day and any family contact that they have. The written plans of care are much improved and they are written in a way that identifies individual needs and what staff must do to meet them. However there is a need for more detail to be included in these areas of the care plans. The use of plain English would ensure that all staff easily understand them. The care plan objectives list four areas, which are strengths, needs, problem and risk. The care plans give instructions on how staff are to address areas of need and risk areas but not how residents strengths are supported. Some revision is also required to ensure that what is recorded is accurate. For example two residents care plans state that staff provide a minimum amount of fluids each day to prevent dehydration. There were no charts in place or any actions to identify how staff were to do this and how frequently. However discussion held with the manager and staff confirmed that these residents did not have any assessed needs relating to dehydration therefore these did not need to be included in the care plan. Another resident who has problems with using speech due to a medical condition, has developed with staff, an effective way of communicating their needs. This is done by use of hand gestures, facial expressions and the use of key words. Discussions with staff confirmed that they are aware of how to communicate effectively to support this person and ensure that at all times their dignity is Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 13 not compromised. However the written care plan does not fully record these positive practices that are being carried out by staff. Care files did confirm that those residents who had been assessed as having problems with mobility and pressure care had received support and input from relevant health professionals. This has resulted in appropriate equipment being provided to help meet their needs. As the home uses a number of standardised forms for assessment and care purposes, staff need to ensure that when they complete these, all areas are filled in. Particularly for the document referred to as the “fall observational chart”. Some of the boxes that require a “yes” or “no” answer are not always completed. And similarly the box that is used to record the observations of staff does not always contain sufficient information. The “life history “ document that is used by staff to record resident’s interests and previous lifestyle is now in the process of being completed by staff and also by involving resident’s families. This is a positive development and it is good that staff are involving the families of the residents to obtain this information. One life history that had had been completed offered valuable information about a resident’s personal history and was assisting staff with their care. Staff work positively with residents and there was a noted improvement with some resident’s personal appearance, particularly for those residents who present behaviours that challenge and who in the past have not responded to staff support. Medication records were examined and were satisfactory. Senior staff are responsible for administering medication and have received training appropriate to this work. Records are maintained for medicines that have to be stored in a fridge. The medication storage area is clean and hygienic and offers a secure facility for the storing of medicines. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service’. Residents are generally helped to exercise choice and control over their lives, taking part in stimulating activities, maintaining contact with family, friends, and representatives. A good range of meals is available which ensures that resident’s dietary needs are met. EVIDENCE: A person has been allocated to the post of activities coordinator, 20 hours per week and has been responsible for developing a number of activities for residents to take part in. An activity planner is on display in various points of the home and activities are listed as taking place in the morning and the afternoon. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 15 The residents have recently been involved in making Easter bonnets and plans are in place to decorate eggs as part of a competition. The first floor has a large display of balloons and Easter chicks as part of a celebration for Easter. Recent events in the home have been a musical show in which staff contributed to the event and discussions with the residents confirmed that this had been an enjoyable experience. Discussion held with the staff confirmed that there are lots of things now being developed in the home to provide additional stimulation for the residents. Discussion with the manager confirmed that a range of events would be organised each month and would include things like Mothers Day, as well as celebrating saint days for people of Welsh, Scottish and Irish backgrounds. One resident was going out shopping with the activities coordinator and they said that they were looking forward to this. There are no restrictions on visiting the home and some residents are visited daily by their families, who assist with their care. One resident had recently been to their daughters for lunch at the weekend and it was stated by the family that it was good that this had been enabled by the home to continue. The manager confirmed that arrangements have been made for Beamish Museum staff to visit the home in March, with items of memorabilia and carry out a reminiscence session with the residents. The home has a range of menus that are referred to as the “Nutmeg diet” offering a range of balanced and nutritious meals, whilst at the same time offering residents choice. Discussion with the cook confirmed that one of the meals on the menu, curry, was becoming popular though there were some meals particularly the pasta dishes that some residents were not keen on. However the cook stated that this did not present a problem as an alternative meal could always be made available. Lunch was taken with the residents and this was an enjoyable experience. The meal was piping hot, of good quantity, well presented and very tasty. Hot and cold drinks were available throughout the meal and tables were nicely set. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 16 The mealtime was unhurried enabling people to have a conversation. The residents confirmed that staff always asked them what they wanted to eat and that the food was always very nice. However there are no menus on display in either of the dining rooms to inform residents what is available at each mealtime. The only menu that is on display is on the notice board in the lobby and due to positioning and size of writing, is not easy to see. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area adequate. We have made this judgment using a range of evidence, including a visit to this service. Residents and their family and friends are confident their complaints will be listened to and acted upon and appropriate procedures are in place to ensure that residents are protected from abuse. However staff require some additional training on how to make an alert using the companies safeguarding adults procedures. EVIDENCE: There is a suggestions box in the entrance lobby of the home and also information is on display advising people how to make a complaint. Discussions were held with relatives who were present during the inspection visit. They confirmed that they had no complaints. They described the new manager as being approachable and that he would address any issues that were discussed with him. One relative gave an example of a matter that had been raised with the manager, which they stated was dealt with immediately and to their satisfaction. During the first day of the visit the inspector was informed by two members of staff of an issue that was causing them concern. Following discussion with Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 18 them it was agreed that this would be reported to the Operations Manager who is responsible for giving oversight to the home. As a result of discussion with the Operations Manager, the company immediately investigated the matter under the safeguarding adults procedures. This included holding strategy meetings and carrying out a detailed investigation. Appropriate representatives from other agencies were involved and a speedy and satisfactory conclusion was reached. As a result of how the alert was made by staff it was identified that the company need to review their procedures with all staff and this is being addressed through training. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, & 26 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service. All parts of the home are well maintained, clean, pleasant and free of odours, ensuring that residents have a good and safe environment to live in. And residents have the necessary equipment to help them with daily life. EVIDENCE: A good standard of housekeeping is in place and there were no noticeable defects or hazards. The first floor, which is mainly occupied by residents who have dementia or memory loss, has a range of visual and tactile symbols and signs evenly placed throughout the corridors. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 20 This assist residents in finding their way around the home, as well as offering interesting items to look at. Pictures of Old Sunderland, which are clearly labelled and easy to read show places of interest that most residents are able to recognise. Where required and following assessment, some residents have been provided with equipment to meet their individual needs. For example raised seats in en suite toilets, commode chairs and appropriate lifting equipment. Assisted baths are available and on testing were noted to be in good working order. Hot water was tested and confirmed that it meets the safe requirement for bathing. Thermometers are available for staff to test the hot water, ensuring the residents are safe whilst bathing. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service’. Residents’ needs are met by sufficient numbers and skill mix of staff and all staff are adequately trained and competent to do their jobs. All information required as part of the recruitment of staff is obtained and only people who are suitable to work in the home are employed, ensuring the safety and wellbeing of residents. EVIDENCE: The staffing levels at the time of the visits were satisfactory for the number of people living in the home. During one of the visits staff training was taking place on fire safety and the safe use of bedrails. Each member of staff has their own individual training file that lists all training attended, as well as a copy of any training certificates they have received. A master training file is also available that confirms future training that has been arranged. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 22 Twenty-two staff recently completed a 12-week distance-learning course on safeguarding adults. Plans have been made for staff to commence another 12week training course from the end of February that will cover infection control. Eight staff have also undergone training that is related to caring for people with dementia. This has assisted staff in their work with people who have dementia as well as giving them a greater understanding of the illness. Since the last visit five new staff have been employed in the home. Records are available in each of their files that confirm all of the necessary checks are carried out to confirm their suitability to work in a care home. Ashton Grange Residential Home DS0000015762.V356003.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. We have made this judgment using a range of evidence, including a visit to this service’. An experienced manager is in post who provides staff with the necessary support and supervision to ensure the health, safety and welfare of the residents is promoted. External quality assurance systems are in place to ensure residents finances are well managed and that the home is run in the best interests of service users. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 24 EVIDENCE: The company appointed a new manager in August 2007. This person has been registered with the Commission before as a registered manager. Though as yet he has not gone though the process of registration in respect of this post and needs to submit an application to the Commission for registration. The manager has 10 years’ experience of working in health and social care settings, of which 9 years’ experience has been gained in working with older people. The manager is currently undergoing the Registered Managers Award through an external training agency and stated he will complete this by the end of February 2008. The manager is not in receipt of a National Vocational Award level 4 in care. In discussion with the manager he confirmed he is aware of the need to keep up to date with practice and continuously develop his management skills. And evidence needs to be available to demonstrate that this is taking place. Since taking up post the manager has begun to make a number of improvements. This has formed a baseline to demonstrate how requirements made in the last report have been addressed and are continuing to be addressed. There are still developments to be made with the written care plans as already stated section 7 of this report, with more detail to be included and for them to be written in a way that all staff easily understand them. Some revision is also required to ensure that what is recorded is accurate and updated to reflect the current work being carried out by staff to support residents assessed needs. Staff also need further support by the manager to ensure that when using the company’s standardised care documents and they are filled in correctly at all times. This will ensure that staff are knowledgeable and competent about how to care for people who are using the service. And also how the records they use support the actions that they are taking to meet residents assessed needs. A start has been made on developing “life histories” for residents as noted in section 7 of this report. The document that is used by staff to record resident’s interests and previous lifestyle needs to be completed for everyone. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 25 This will provide additional evidence to demonstrate how the service is user focused and takes into account the views of residents and also their families. Evidence available in the home confirmed that work is being carried out in this area by staff but so far is still under development. The manager is ensuring that staff receive regular formal supervision which covers their working practices and also identifies any future training needs. Formal supervisions have only commenced since the manager started. Once they have become established as regular working practices it will ensure that staff continue to receives the support to offer a good service to the residents. It will also ensure that staff are fully involved in the planning of the care and the routines of the home. Since the last inspection visit increased external management support has been provided to the home from the companies Operations Manager. This has ensured that a number of positive changes particularly in relation to fire safety, staff training, environment and care practices have taken place in the home. All staff now receive regular fire instruction and fire drill training and also the use of fire extinguishers. This ensures that staff knows what to do in the event of an emergency. Records of accidents are kept and these were checked against other records that the home keeps. This confirmed that staff followed the correct procedures when dealing with accidents. However the falls observational charts that are used by staff to record the actions taken after a fall have gaps in the information. This was discussed with the manager who was advised that all entries made should be clear and up to date. The company carried out an external audit of monies held on behalf of residents the day before the visit and this confirmed that the system is effective. The manager is receiving regular support from the Operations Manager who also carries out monthly visits to audit the work that is being done in the home. As a result clear guidelines are offered to the manager as to what areas of work need to be developed. As reported in section 16 of this report some review is required of the reporting procedures that relate to safeguarding adults and this was discussed with the Operations Manager. This will ensure that the systems of protection in place to support vulnerable adults are robust and fully understood by all staff. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 26 Staff morale is high and there was a pleasant atmosphere throughout the visit. Staff spoke well of the manager and confirmed that he is making positive changes in the home. The staff also confirmed that the manager had a good style of leadership and discussed developments with them. Positive improvements have been noted as discussed in the introduction of this report and the manager now needs to demonstrate that the improvements being made continue to be reviewed and maintained. As part of this visit a review of registration was carried and this confirmed that the certificate of registration was not on display or available for examination. This had been removed from the home by a previous operations manager and not returned. This was discussed with the Operations Manager who was advised of the statutory requirement in accordance with Part 11, section 28 sub section 1 of the Care Standards Act 2000, which is to ensure that the registration certificate is made available in the home and displayed in a prominent area. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 27 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 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 28 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. Standard OP7 Regulation 15 (1) Requirement Residents care plans must continue to be developed as advised within this report. And as discussed during the visits. Individual assessment of needs and life history documents must continue to be updated. The manager must submit an application to the commission to be registered. Timescale for action 31/08/08 2. OP7 14 (2) (a) & (b) 8 31/08/08 3. OP31 31/03/08 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 OP15 Good Practice Recommendations Consideration needs to be given to ensure that menus in a variety of forms both written and pictorial are available in the dining rooms. Ashton Grange Residential Home DS0000015762.V356003.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000015762.V356003.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. 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!