Inspection on 03/04/07 for Ashton House Nursing Home

This inspection was carried out on 3rd April 2007.

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

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

CARE HOMES FOR OLDER PEOPLE Ashton House Nursing Home Bolnore Road Haywards Heath West Sussex RH16 4BX Lead Inspector Mrs S Gawley Unannounced Inspection 3rd April 2007 09:30 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 House Nursing Home DS0000067383.V331898.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 House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton House Nursing Home Address Bolnore Road Haywards Heath West Sussex RH16 4BX 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) 01444 459586 01903750194 awbashtonhouse@btconnect.com Ashton Healthcare LTD Miss Irene Chong Miss Phaik Guat Khoo Care Home 91 Category(ies) of Dementia (91), Dementia - over 65 years of age registration, with number (91), Mental disorder, excluding learning of places disability or dementia (91), Mental Disorder, excluding learning disability or dementia - over 65 years of age (91), Old age, not falling within any other category (91) Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Ashton House Nursing Home is now registered for 91 residents as it has recently been successful in a variation process having increased its capacity with the building of an extension. It is currently awaiting the documentation and certificate relating to this. It is a detached property, which has two wings, one catering for dementia nursing the other for elderly frail nursing. Accommodation is provided over three floors It is situated on a quiet lane on the outskirts of Haywards heath and it’s amenities. There are well maintained grounds and ample parking. The fees are £460 to £800. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit as part of the inspection process took place on 03 04 07 between 09.30 and 15.00 Both of the registered managers facilitated the inspection. One deals mostly with aspects of care and the other aspects of administration and training. A pre inspection questionnaire had been forwarded to the commission and any documents required on the day were made available. 30 comment cards were received from residents, many filled out with the aid of relatives who added their own comments. Four were received from professionals. These comments were all positive. Comments from professionals elicited by the homes own quality assurance systems were seen in the home and these were also very positive. Six residents were case tracked, their care plans and medicine administration charts were inspected, and those able to communicate were spoken to. Three relatives were spoken to and all spoke very highly of the home and the care offered, which they said was delivered in a respectful manner. They also stated that the activities were appropriate. The atmosphere in the home was very relaxed and sociable. Many of the residents were sitting in the lounge. This report is compiled using information as described above and also information held on file at the Commission. All of the standards were met today mostly judged as good, with the exception of the administration of medicines, which is detailed in the report. Residents in this home experience a very good standard of care from dedicated staff. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There is a shortfall in the administration of two medications in that it is the practice of the home to dispense from one named residents bottle/pack to all. This was discussed with the manager who will ensure this practice will cease. This is a requirement of this inspection process. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 7 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 House Nursing Home DS0000067383.V331898.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 House Nursing Home DS0000067383.V331898.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): 2, Residents had been assessed before moving into the home. The staff at the home are meeting identified needs Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: All relatives spoken to stated that they received enough, relevant information prior to admission and that pre admission assessment, of residents was undertaken prior to admission. Pre admission assessment documentation was seen in care plans inspected. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 All residents have an individual care plan which sets out their needs. Policies and procedures are in place on administration of medicines to protect residents but not all medicines are administrated appropriately. Care staff are meeting the health care needs of the residents in a respectful manner. Residents will be treated with care and will have their wishes respected at the time of death. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 11 EVIDENCE: Six residents were care tracked. Care plans were inspected and had information on all aspects of health personal and social care. All areas such as sleep, nutrition, mobility, communication and mental state were up to date. The plans showed evidence of regular review and also the input of any other medical or health professional. Three of these six residents were spoken to as were the relatives of two. The relatives they all expressed pleasure with the home and the care received. They were complimentary of the kindness of the staff and said that everyone is treated with respect. One relative stated that the home is very good at reporting even minor issues and that they are involved in the drawing up of care plans. Another stated that staff are like extended family. All comment cards expressed satisfaction with the care received. The medicines were inspected and were found to be appropriately stored. All medicines received, administered and disposed of by the home were recorded. The medicine administration charts for the residents case tracked were up to date. There was evidence in care plans of regular review. Several residents are prescribed Lactulose and Adcal but it is the practice of the home to dispense from one residents bottle/pack to all. This was discussed with the registered manager who will ensure this practice will cease. Relatives confirmed that resident have freedom and choice in their daily activities such as rising and where to take meals. Relatives confirmed that residents are always appropriately dressed and clean. Comment cards from three General Practitioners confirmrd that they can see the residents in private. Two carers were observed offering care in a respectful and appropriate manner and using the correct equipment. The manager discussed the homes intention to meet the Quality Service Framework for end of life care and provided document\ary evidence of this. One relative spoken to confirmed that this had been discussed with her and she found that comforting. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Activities are provided to enhance the lifestyle of residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s social needs and hobbies are recorded in the care plans. All comment cards received stated that the activities are appropriate. Although some residents state that do not always want to join in. One General Practitioner commented that one resident’s love of gardening was encouraged. Activities are prominently displayed on notice boards and include outings, in house activities and external entertainers. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 13 There is contact with the local clergy. There is a Church of England service monthly and the Roman Catholic clergy visit residents individually or pick up and take to church. Other faith needs are met as they arise. Relatives spoken to and comments in the comment stated that visitors are positively encouraged, are always made welcome and are offered refreshment. Lunch is offered free of charge. All comment cards expressed satisfaction with the food, one relative stated that her father was fussy but the home tried to please him. The meal seen prepared and served today was appetising and nutritious as described. Choice is offered to residents. There are pleasant dining areas and residents have choice in where to take their meal. The most recent environmental health report stated that there was a high standard of food practice. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 14 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 There is a complaints procedure in place which residents and relatives are aware of. Adult protection policies, procedures and training are in place to protect residents, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place. Relatives spoken to confirmed that they are aware of this but all stated that there was not any need to complain. They stated that any minor issues arising was discussed with staff and rectified immediately. There have not been any complaints since March 06. The 4 professional comment cards stated that they had not received any complaints regarding this service. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 15 Adult protection procedures are in place and training records evidence that there is staff training on Adult protection. Staff spoken to demonstrated knowledge of these procedures. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Residents live in a safe and comfortable home. The home is clean and hygienic Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: All parts of the home inspected were neat, clean and free from offensive odour. All areas are decorated and furnished to a high quality. Rooms were personalised with resident’s own belongings. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 17 The sitting areas, dining and outdoors space are attractive and comfortably and tastefully furnished. Residents confirmed that they are satisfied with the comfort and furnishings in the home. There are three passenger lifts allowing access to all parts of the home. All equipment such as wheelchairs, hoists, pressure relieving equipment assisted baths are in place to meet residents needs. There are adequate bathing, shower and toilet facilities throughout with most of the rooms having ensuite facilities. There is a dedicated fitted hairdressing room. All sinks have temperature control valves and temperatures are recorded monthly. Radiators are covered or have low temperature surfaces. A recent extension has just been approved which, when the documentation is in place will increase the number of residents to 91. Documentation seen during the visit evidenced that fire; utility and equipment checks and maintenance have been carried out. Fire alarms were being tested during the inspection. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 The numbers and skill mix of staff meets resident’s needs. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: Adequate numbers of staff were on duty. Residents spoken to stated that when they call for a member of staff there is not any delay in someone attending. One General Practitioner comment cared received stated that the “overall care is excellent.” The home facilitates the supervised practice of Overseas Nurses Programme which nurses take in order to register in this country. This is supervised and supported by the University of Sunderland. The home also takes Pre Registration Nursing students for short placements from the University of Surrey. One of the registered managers is responsible for training and supports these students with the aid of mentors. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 19 Staff spoken to all stated that they feel there are enough nurses and carers on duty to meet resident’s needs and to keep them safe. Recruitment files inspected show the necessary documentation to ensure the safety of residents. There is a comprehensive well-managed staff training and induction programme in place, which staff confirm they receive. This includes mandatory training and further areas of special interest. Evidence of this training was seen on inspection. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Residents live in a home, which is managed by a person who is fit to be in charge. The home is run in the best interests of residents. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 21 The two registered manages have worked in the home for twelve and fourteen years. The division of management responsibilities has achieved good outcomes for residents. One concentrates on the care management of residents and the other on training, quality review and other administrative functions of the post. A General Practitioner, as stated earlier, commented that the overall standard of cares “is excellent” and the home is implementing the Quality Service Framework for end of life care. Staff spoken to feel confident and well supported in their work and feel part of a team. One member of staff said, “there is a good staff team”. Staff training and supervision is in place. Records of this were seen and staff spoken to confirmed that they receive this training and supervision. Resident’s finances are not handled by the home. Quality assurance systems are in place to ensure the home is run in the best interests of the residents. Annual surveys are sent to residents and to professionals. Results of these are collated and these were available for inspection. These results mainly reflected positive comments The health, safety and wellbeing of residents and staff is ensured through the provision of a staff training programme, up to date policies and procedures and the ongoing compliance of the home with the environmental and fire authorities. Documentary evidence of this was seen during the visit and was up to date. Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 4 X 3 X 3 X X 3 Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 (2) Requirement The registered person must ensure that service users receive medication from the container the pharmacist has supplied to the service user named on the label. Timescale for action 10/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashton House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 House Nursing Home DS0000067383.V331898.R01.S.doc Version 5.2 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. 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