Inspection on 16/08/05 for Ashton House

This inspection was carried out on 16th August 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 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 House 09/08/06

Ashton House 02/02/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashton House Union Street Stow-on-the-Wold Gloucestershire GL54 1BX Lead Inspector Eleanor Fox Unannounced 16 August 2005, 09:30 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 House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ashton House Address Union Street Stow-on-the-Wold Gloucestershire GL54 1BX 01451 830843 01451 831798 manager.ashton@osjct.glos.co.uk The Orders of St John Care Trust 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) Mrs Maggie Keyte Care Home with Nursing 45 Category(ies) of DE Dementia (10) registration, with number OP Old Age (35) of places Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) One named service user under 65 years to be accommodated for respite care. Date of last inspection 7/02/05 Brief Description of the Service: Ashton House is a purpose built well-appointed Care Home, situated within easy reach of the town centre of Stow-on-the-Wold. The Home offers personal and nursing care to the elderly service users; it is managed by The Orders of St John Care Trust. Ashton House has 42 single rooms and a double room, which is currently accommodating one resident, and has homely communal accommodation on both floors. A shaft lift has been installed for easy access to the upper floor; the Home is also well equipped with a variety of disability aids. Part of the ground floor has been converted to provide secure accommodation for ten elderly people who suffer from dementia. Consideration is being given to extending this facility. The residents have secure access to the extensive attractive private gardens that surround the property. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection over a period of 6.5 hours. It consisted of discussions with the Manager, members of her staffing team, and the Care Leader in charge of Sunnyside, the area dedicated to the care of elderly people suffering from dementia. She inspected a selection of written care records, recruitment files and other available documents; and also walked around the property and part of the gardens. The inspector had the opportunity to talk to six of the residents and to three relatives who were present in the Home. She selected the residents in a random fashion and looked at their bedrooms and all areas of their daily lives during her visit. Management of the Home has recently become the responsibility of The Orders of St. John Care Trust. The Commission for Social Care Inspection has fully processed their application for registration. What the service does well: What has improved since the last inspection? The Home continues to improve on the standard of care planning for the residents and now provides clearly detailed information on the care of each person in the Home. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 6 A thorough assessment process plus the provision of detailed information about the Home, enables the majority of prospective residents and their advocates to make an informed decision regarding their admission and gives them assurance that their needs will be met. EVIDENCE: The Home now provides each service user or their advocate with detailed information about the levels of any ‘RNCC’ financial contribution to which the resident may be entitled. Copies of the documentation supplied are also kept in the residents’ personal files. However, in recent months, only residents who are privately funded have received a copy of the terms and conditions for admission to the Home. Most of these details may be read in the service user guide, which is readily available in the front hall of the Home. A comprehensive assessment of each resident’s care needs is undertaken prior to their admission to the Home. The completed documentation is retained in the care records. The Home also has the benefit of any Social Services or other assessment, which may have been undertaken on the prospective resident. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 9 Intermediate care is not provided in this Home. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 and 11. The care planning systems in place provide the staff with the information they require to care for all the residents’ needs throughout their stay at the Home. Care is delivered in a manner that preserves the residents’ privacy and upholds their dignity. EVIDENCE: The care planning documentation for seven of the residents was read in detail on this occasion. In every case these provided clearly detailed information about the specific care needs of each person. All were reviewed in a timely manner. One carer who was working in the Home in a relief capacity appeared to have a good understanding about the care needs of the resident she was assisting. Where residents had been identified as ‘at risk of developing pressure sores’, appropriate care had been instigated and specified equipment provided. Support and care from relevant healthcare professionals was sourced when required. Good ‘control of infection’ measures were being observed to contain the infection from which some of the residents were suffering. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 11 Some of the residents not living in the specialised Sunnyside unit may be suffering from confusional states, which outweigh any physical disabilities they may have. These people have not been reviewed recently to ensure that the Home complies with current registration categories. People living in the Home were treated in a respectful but sensitive and pleasant manner. The relatives present in the Home were particularly complimentary about the kindness and friendliness of the staff. Each resident was dressed in clean well presented clothing. One seriously ill resident passed away peacefully during the afternoon; a member of staff was with her when she died. This person appears to have received attentive and appropriate care in her final hours; her family members were kept informed of her condition and treated with respect and sympathy by the staff. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 Residents receive considerate respectful support from the staff to exercise choice in their daily lives. EVIDENCE: Residents in the Home were assisted to live as independent a life as possible. They were free to get up and to retire when they wished and to eat their meals in the dining room, their own bedrooms or in any other area of the building, if they preferred. Many had numerous personal possessions in their rooms, including small pieces of familiar furniture where this could be accommodated. One lady took pleasure in showing the inspector her collection of ornaments. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 A satisfactory complaints system enables service users and their families to feel assured that their views would be listened to and acted upon. EVIDENCE: The Home has a written Complaints Procedure, which is readily available to residents, their visitors and members of staff working at Ashton House. The processes are explained in the Home’s brochure and are also outlined in the Service User Guide file, which is kept in the front hall. There have been no formal complaints in recent months. One visitor had had no reason to raise any concerns but was aware of the complaints procedures in the Home. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 A safe and well maintained environment provides residents with a reasonable standard of accommodation. EVIDENCE: All areas of the Home visited on this occasion were clean, well maintained and reasonably decorated; each room was equipped with strong robust furniture. There was a quiet peaceful atmosphere throughout the property. Although a very warm day, the building was fresh and well ventilated. Laundry facilities are well organised; the assistant has good knowledge of control of infection protocols. Personal clothing is ironed and labelled so that it may be returned to the correct owner in an acceptable condition. Some of the equipment now requires repair; the assistant is making temporary alternative arrangements. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 15 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 and 29 Skill mix and staffing numbers are adequate to meet the needs of the residents living in the Home. Recruitment processes require improvement to ensure the protection of residents living at Ashton House. EVIDENCE: There were forty-three residents living in the Home although one person had been hospitalised following a recent fall. In the morning, the Manager, her Deputy plus eight carers were in the Home to look after the people living there; one nurse and six carers were due to be on duty in the evening; with a nurse and two carers working at Ashton House overnight. Although there are only five residents requiring nursing care at the current time, most are high dependency and many have varying degrees of confusion requiring specialised care. Members of staff and visitors to the Home all confirmed that, at times, the staff “are very stretched” although one relative stressed that “everyone is very good natured, even when they are busy”. Two people had been employed in the Home in recent months. On the whole, robust employment procedures had been followed: each person had completed an application form, attended a formal interview and had been appropriately screened. However, information about their full employment history plus the reasons for any gaps in employment is not yet obtained, as is required. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 16 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) 31, 35 and 38 Management systems are in place to ensure that the financial interests, and the health, safety and welfare of people using the service are safeguarded. EVIDENCE: The Registered Manager, an experienced qualified nurse, has just successfully completed the Registered Managers Award. The Administrator takes responsibility for the personal monies for over the majority of the residents; seven were selected for inspection. The money is maintained correctly in individual secure storage and the records are completed correctly. Each person’s status relating to Power of Attorney is also ascertained and recorded. On the whole, ‘Health and safety’ issues are addressed well at this home but training on fire precautions and updates in manual handling are now overdue. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 17 Senior staff have had formal training in First Aid. All necessary maintenance of equipment is undertaken in a timely fashion. Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 18 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 x 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x 3 x x 2 Ashton House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 19 No 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 2 Regulation Requirement Timescale for action By 30.10.05 By 30.9.05 By 30.9.05 2. 3. 26 29 4. 38 5. 38 Regulation Each person must be provided 5 with a written copy of the terms and conditions for admission to the Home Regulation The laundry equipment must be 23(2c) kept in good working order Schedule Each employee must provide a 2.6 full employment history plus a satisfactory explanation for any gaps in employment Regulation Members of staff must receive 13(5) and timely training in the moving and Regulation handling of service users 18 (1c) Regulation Members of staff must receive 23(4d) suitable training in fire prevention By 31.10.05 By 30.9.05 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 7 Good Practice Recommendations It is strongly recommended that reviews of the current service users be undertaken to ensure that the Home fully complies with its registration categories. D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 20 Ashton House Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 House D51_D03_s64572_Ashton House_v239398_160805_stage 4.doc Version 1.40 Page 21 - 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!