Inspection on 18/04/07 for Ashton Lodge

This inspection was carried out on 18th 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

Ashton Lodge 17/10/05

Ashton Lodge 24/05/05

Ashton Lodge 09/02/05

Ashton Lodge 05/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ashton Lodge 22 St Michaels Road Maidstone Kent ME16 8BS Lead Inspector Helen Martin Unannounced Inspection 18th April 2007 2:30 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 Lodge DS0000023889.V336681.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 Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton Lodge Address 22 St Michaels Road Maidstone Kent ME16 8BS 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) 01622 677149 ashton.lodge@tiscali.co.uk Mr Ramdass Varathy Ramasawmy Mrs Manoon Ramasawmy Mrs Manoon Ramasawmy Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2005 Brief Description of the Service: Ashton Lodge can provide care and accommodation for up to twelve older people. The home is located approximately ½ mile from Maidstone town centre with easy access to public transport. The nearest shops, church, pubs, post office are within easy walking distance. Ashton Lodge is a large house that has been converted to a residential home, having accommodation on the ground and first floors. The home has ten single and one double room, each room is fitted with a call alarm and television point. The double bedroom is currently used for single occupancy. The home has facilities for car parking at the front of the building. Mr and Mrs Ramasawmy own the home. Mrs Ramasawmy takes control of the day-to-day management. The care staff work on a roster system, which gives twenty-four hour cover. The owners and staff currently undertake all duties in the home including cooking, cleaning and entertainment. Current fees for the home range from £315.00 to £350.00 per week and do not include hairdressing, taxis, toiletries, chiropody or personal papers and magazines. Full information about the fees payable, the service provided, the home’s Statement of Purpose and the latest inspection report by the CSCI are available from the owners. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 18th April 2007 and included talking with the manager, one member of staff and three people who live in the home. Some judgements about the quality of life within the home were taken from observation and conversation. Some records were looked at. A tour of the house and garden was undertaken. A completed pre-inspection questionnaire has been received from the home. This has been used within the inspection process and information has been included within this report where appropriate. Currently there are ten residents accommodated. The shared room is presently used for single occupancy. Comments made by residents spoken with at the time of this visit included: I was in hospital before I came into the home I like it here I saw a speech therapist this afternoon and they gave me advice, they were helpful I get my medication on time I can choose when to get up and go to bed I like to listen to tapes of library books; it is a good system I was in the lounge this morning taking part in the crossword; I enjoyed it a lot My daughter visits every other day and my son has visited several times Food is good, I have pureed food and prefer it mixed up together Staff ask if I like the food The food is very tasty The food is very good; it is cooked by the manager I have no complaints I like my room The owner decorated my room to my taste I haven’t used the laundry yet Staff are very nice, pleasant and helpful; they come quickly when I use my emergency buzzer Staff appear when you want them The help from staff is comforting The staff are very good, they will do anything for you The staff are very nice What the service does well: Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 6 Individuals are given the information they need before they decide to move into Ashton Lodge. Procedures are in place to ensure that the home is suitable to meet prospective residents’ needs. Individuals enjoy living in a home, which is run in their best interests by a competent manager and appropriately supervised staff. They enjoy living in a clean, comfortable, warm and homely environment. Residents are treated with respect. Arrangements are in place to maintain their privacy and dignity. Residents’ personal, health and social care needs are met. Individuals benefit from a sufficient number of staff who care for, understand and anticipate their wishes. The views of residents are listened to and receive appropriate consideration. Residents are recognised as individuals and are able to exercise choice over their lives. They enjoy their lifestyle within the home and are able to keep in contact with their family and friends if they wish. Residents benefit from a varied and balanced diet. The regular testing and maintenance of systems and equipment within the home protects their health and safety. They are protected from potential abuse. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 7 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 Lodge DS0000023889.V336681.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 Lodge DS0000023889.V336681.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): 1, 2, 3, 4, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are given the information they need before they decide to move into Ashton Lodge. Procedures are in place to ensure that the home is suitable to meet prospective residents’ needs. EVIDENCE: There is a statement of purpose and service users guide, which gives written information about the home. Residents have contracts, which detail their terms and conditions of accommodation. Residents are assessed before they move in, in order to ensure that the home is suitable to meet their needs. Assessments undertaken are recorded. The manager mentioned that residents had the opportunity to look around before Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 10 they decided to move in. All residents spoken with said they were happy at the home. Although intermediate care is not provided, some respite care can be offered. Ashton Lodge DS0000023889.V336681.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, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect. Arrangements are in place to maintain their privacy and dignity. Residents’ personal, health and social care needs are met, although a review of some care plans would better reflect this. Residents’ protection could be enhanced by some improvements to the procedures in place for the administration of medication. EVIDENCE: Individual plans of care for each resident are developed from assessments undertaken prior to their admission to the home. These identify the support required from staff to meet residents’ personal, social and health care needs, including activities, continence and nutrition. One resident’s care plan did not include any information about their Diabetes. Risk assessments are undertaken for a range of issues, although one was not in place regarding an individual’s mobility problems. Hand-written notes are kept of the day-to-day support Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 12 provided. All the information seen had been reviewed and updated on a regular basis, with the exception of two moving and handling assessments. Social Services also undertake some reviews. The manager was in the process of developing a plan of care for one newly admitted resident. Care plans are audited by the home and signed by residents. Records seen confirmed that a range of health and social care professionals are accessed to support staff to meet residents’ needs. The manager said that residents had had input from the District Nurse, Community Psychiatric Nurse, Physiotherapist and the Kent Association for the Blind when necessary. One resident said that they saw a Speech and Language Therapist on the day of the inspection, who was helpful and gave them advice. No residents have pressure sores and specialist equipment can be provided where necessary as a preventative measure. Residents’ nutrition is monitored and they are weighed monthly. The home’s latest quality assurance questionnaires indicate that residents feel happy that their needs are met. Staff enable one Diabetic resident to administer their own insulin. Although the Diabetic Nurse has assessed the individual as capable of doing so, this is not recorded. Risk assessments and staff guidelines are available together with ongoing monitoring by the Diabetic Nurse. Staff manage all other medication for residents’; an easily monitored system is used. Administration records are completed appropriately after staff observe that residents have taken their medication. Suitable checks and written confirmation is available for hand written entries. The manager assured the inspector that one dosage amendment was due to be signed shortly by the GP when they next visited the home. Medication is stored in two cupboards, which since the last inspection have been secured to the wall. One is a designated drugs cabinet and the other is not, also housing files and other items. The manager stated that they were in the process of obtaining another drugs cabinet. No designated storage facilities are provided for controlled drugs or medication requiring refrigeration. Appropriate medication guidelines and reference material is available. The manager said that the home’s policy and procedure had been updated since the last inspection. Residents confirmed that they get medication on time. All staff who administer medication are trained although some updates are needed. Residents spoke very highly of the staff team, including ‘staff are very nice, pleasant and helpful; they come quickly when I use my emergency buzzer; staff appear when you want them, the help from staff is comforting; the staff are very good, they will do anything for you.’ The home’s latest quality assurance questionnaire confirmed that residents’ privacy and dignity was respected. During the inspection, staff were seen to attend to individuals’ needs in privacy and respond quickly when asked. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 13 Ashton Lodge aims to provide residents with a home for life; if possible an individual who was dying would be supported to spend their last days in the home in familiar surroundings with people they know. The manager demonstrated a good understanding of the needs of residents and their families at this time. Ashton Lodge DS0000023889.V336681.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. This judgement has been made using available evidence including a visit to this service. Residents are recognised as individuals and are able to exercise choice over their lives. They enjoy their lifestyle within the home and are able to keep in contact with their family and friends if they wish. Residents benefit from a varied and balanced diet. EVIDENCE: The routines of the home are generally flexible. One resident spoken with said that they could choose when to get up and go to bed. The home’s latest quality assurance questionnaire indicated that residents were happy with issues regarding visitors to the home and their independence and choice. Those spoken with enjoyed their lifestyle and described their daily activities and interests as including listening to tapes of library books and crosswords. The manager said that there is an activities programme that includes an Easter party with entertainers, making Easter hats, walks, using the garden, sing a longs and a Christmas party. Quizzes are a favourite. One resident goes out on Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 15 their own and goes to church; ministers now come into the home. Records confirm that a range of activities is available. Residents are encouraged to keep in contact with their relatives and friends if they wish. Visitors are welcome in the home at any reasonable hour. Some residents spoken with confirmed that they enjoyed visits from members of their family. Residents spoken with said the quality of the meals was very good; the food was tasty and presented in a way that they liked. The menu is planned in advance and showed a variety of meals including options for breakfast, lunch and supper. Residents are asked daily for their choice of meals and records seen confirmed this. Specialist diets can be catered for, such as diabetic, soft and pureed. The latest quality assurance questionnaire showed that residents are happy with the choice, presentation, temperature, size and ordering of food. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 16 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 is good. This judgement has been made using available evidence including a visit to this service. The views of residents are listened to and receive appropriate consideration. They are protected from potential abuse, although a review of the written policy would better reflect this. EVIDENCE: At the time of this visit, residents were at ease talking with staff and those spoken with had no complaints about the home. The latest quality assurance questionnaire indicated that residents were happy and knew who to complain to if they wanted to do so. The manager said that no complaints had been received and records seen confirmed this. The home provides a written complaints policy and procedure. The manager demonstrated a good understanding of the protection of vulnerable adults; they have obtained the recent Kent and Medway procedures. The home provides it’s own policy and procedure, although this does not include specific information regarding referral to social services. The manager said that some training updates are needed for adult protection. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 17 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, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in a clean, comfortable, warm and homely environment. EVIDENCE: The home is comfortable, warm and homely. All areas seen were clean and tidy. Residents use the garden. The manager stated that they had obtained previously planning permission for an extension but work had not yet started. There are sufficient lounge, dining, bathing and toilet facilities. Individual rooms reflect the occupants’ personalities and have personal effects and are very pleasant. One resident spoken with said ‘I like my room, the owner decorated my room to my taste’. There is one shared bedroom, which is currently used for single occupancy. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 18 Aids and equipment to give increased confidence and support are provided as necessary. The home is warm and well lit and rooms are naturally ventilated. The manager stated that, since the last inspection the hot water and central heating system have been repaired and/or replaced. The kitchen and laundry area are maintained in a hygienic manner. The manager said that the Environmental Health Officer is aware of the one sink in the laundry and has not any recommendations regarding this; a recommendation from the last visit has been addressed. There is a risk assessment in place and an infection control procedure in place. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. Residents benefit from a sufficient number of staff who care for, understand and anticipate their wishes. Residents’ protection could be enhanced by some improvement to the systems for staff recruitment and training. EVIDENCE: There is good staff interaction between residents and staff. Residents said that ‘staff are very nice, pleasant and helpful; they come quickly when I use my emergency buzzer; staff appear when you want them, the help from staff is comforting; the staff are very good, they will do anything for you.’ Staffing levels during this visit was adequate and records seen confirmed this. No ancillary staff are employed for catering or domestic duties. The staff recruitment procedure in place within the home protects residents. Records seen evidenced that all pre-employment checks had been undertaken appropriately, although the staff application form requests details of previous employment over the last five years and not a full history. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 20 After appointment, all new staff are provided with induction training. Although records seen confirmed this, detail was brief. The manager said that they have obtained information from Skills for Care and will review the recording of induction in line with this. Staff training takes place on an ongoing basis. Records and certificates indicate that staff are receiving a range of training around meeting the needs of older people, such as first aid, dementia care, nutrition for older people/food hygiene and challenging behaviour. It was said that all staff undertook fire training the day before this visit. The manager stated some future staff training booked includes moving and handling and eating and feeding to be provided by the speech and language therapist and dietician. Some training updates are needed for medication, infection control and adult protection. There are some gaps in moving and handling training. Records show four out of ten staff have NVQ qualifications and one is a trained midwife; a further three are undertaking an NVQ currently. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in a home, which is run in their best interests by a competent manager and appropriately supervised staff. They could benefit from the development of the quality assurance system. The regular testing and maintenance of systems and equipment within the home protects their health and safety. EVIDENCE: The manager is experienced and knowledgeable about the needs of older people who require residential care. The manager stated that they obtained a Registered Manager’s Award last year. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 22 The atmosphere of the home is open and inclusive and individuals spoken with confirmed this. There is discussion on a day-to-day basis. Discussion with staff and records seen confirmed that regular staff supervision takes place and includes identification of training needs and annual appraisals. The home has their own quality assurance system, which includes questionnaires being sent to residents. Records seen indicated that residents were happy with a range of issues, some of which have been mentioned previously within this report. Although very positive comments were seen from a social worker, the home does not routinely include health and social care professionals or relatives of residents within the formal quality assurance system. The manager said that these questionnaires would be sent out in future. Since the last inspection regular visits to the home have been undertaken and recorded by the owner. The home provides a range of written policies and procedures, some of which have been mentioned previously in this report, although there is no specific policy regarding pressure relief. The manager stated that the home does not hold any cash on behalf of residents. Accidents and incidents are recorded appropriately. Other records seen indicated the regular testing and maintenance of systems and equipment within the home. Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X N/A 3 3 3 Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18(1)(c)(i) Requirement The registered person shall…ensure that the persons employed…to work at the care home receive training appropriate to the work they are to perform. In that, a review must take place to ensure that all staff training is appropriately updated, including medication, infection control, adult protection and moving and handling. Timescale for action 23/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that, with regard to care plans: 1. A review should be undertaken to ensure that all Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 25 residents with Diabetes have a specific care plan and risk assessment recorded. 2. A review should be undertaken to ensure that all residents with mobility problems have a specific risk assessment recorded. 3. All moving and handling assessments should be regularly reviewed alongside the associated care plans and risk assessments. 2 OP9 It is strongly recommended that, with regard to medication: 1. Assessments of residents’ capacity to self-administer insulin should be recorded by the appropriate health care professional. 2. The manager should complete their stated intention to provide a designated drugs cabinet for all medication. 3. Designated storage facilities should be provided for controlled drugs. 4. Designated storage facilities should be provided for medication that requires refrigeration. 3 OP18 It is recommended that the adult protection policy and procedure should be reviewed in include specific detail regarding the referral to social services. It is strongly recommended that the staff application form should be expanded to provide the facility to record a full employment history and not only that over the last five years. It is recommended that the manager complete their stated intention to review the recording of staff induction in line with Skills for Care. It is recommended that the manager complete their stated intention to include feedback from relatives of residents and health and social care professionals in the formal quality assurance system. It is recommended that the home should provide a written policy and procedure regarding pressure relief. DS0000023889.V336681.R01.S.doc Version 5.2 Page 26 4 OP29 5 OP30 6 OP33 7 OP33 Ashton Lodge Ashton Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lodge DS0000023889.V336681.R01.S.doc Version 5.2 Page 28 - 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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