Inspection on 24/05/05 for Ashton Lodge

This inspection was carried out on 24th May 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 Lodge 18/04/07

Ashton Lodge 17/10/05

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 Maria Tucker Unannounced 24 May 2005 16:00 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 Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashton Lodge Address 22 St Michaels Road Maidstone Kent ME16 8BS 01622 677149 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) Mr Ramdass Varathy Ramasawmy Mrs Manoon Ramasawmy Care Home 12 Category(ies) of Old age (12) registration, with number of places Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9 February 2005 Brief Description of the Service: Ashton Lodge is a large house 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 staff work on a roster system and have one waking and one sleeping care staff at night. The care staff and Manager undertake all of the duties in the home including cooking, cleaning and entertainment. The owner is a registered Mental Nurse and has qualifications in management and is an NVQ assessor.The homes aims and objectives are to provide a warm and friendly atmosphere, which reflects service users individuality. Ashton Lodge aims to provide a home for life. 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. The home has facilities for car parking at the front of the building. The home currently has an all female service user group. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 15.24pm until 18.25pm. Time was spent meeting the manager and staff going through various records and documentation. About one and a half hours was spent meeting service users individually and as a group. Two staff on duty was spoken with. One relative was spoken with. A partial tour of the premises was undertaken. What the service does well: What has improved since the last inspection? Following assessment, communication between the home to the service user has improved and now includes confirmation that the home can meet the service users needs. There have been some internal improvements as part of the homes refurbishments this has included an automatic door closing device. The service users private rooms have been audited to ensure that they have furniture of service users personal choice. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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 Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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 Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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, 4, 5 6, Service users have the opportunity to decide whether the home is suitable for them and their needs can be met. Making these decisions is well supported by staff at the home. EVIDENCE: A newly admitted service user spoke of how that they were “considering staying at the home”, that there was “so much here I like”. They were due to visit another home “just to satisfy myself, Manoon (the manager) knows this”. Staff and the manager relayed how it is very important for service users to be happy and feel that this is the place for them. A letter sent by the manager to a service user before they moved in was seen in a file. The letter recorded that they were ‘pleased to inform’ the service user that following the assessment they were offered a place and the home could meet their needs, ending with ‘I look forward to receiving you in the home and hope you enjoy your stay’. The letter also confirmed the trial period. A copy of the homes assessment was seen in a file. The assessment was comprehensive and formed part of the care plan which had been signed by the service user, reviewed regularly and dated. A relative spoke of how they had attended a review shortly after their relative had moved into the home. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 9 The manager has contacted the inspector to discuss some of the assessments made by the home for prospective service users. The home does not provide intermediate care. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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, Service users needs are central to the maintenance of health, welfare, privacy and dignity. EVIDENCE: Copies of service users care plans are contained securely within their personal file. A service user’s file inspected was signed by the service user and had been regularly reviewed. Following a change of need a review had been held attended by the care manager, a copy of the review was seen. Service users spoken with did not know when their reviews were due, a relative said that they thought one was due soon. A care plan recorded that a service user was frightened to use the lift therefore staff are to escort in the lift; this was confirmed by the service user and in practice. The district nurse’s notes detailed visits and actions taken, including physiotherapy. An entry in these notes evidenced good practice and working relationships stating “resident consented to walking with frame, with me and carer, Manoon present”. During the inspection a staff member was escorting a service user to a medical appointment, on their return the service user said that the staff “looked after me first class, she was my escort”. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 11 A relative commented that the service user had purchased a pressure-relieving cushion. A service user commented that sometimes at bedtime their bottom was a little sore. No service users have pressure sores. The manager has identified the need for chair cushions and stated that she had discussed this with a manufacturing company. Records indicated service users preferred term of address. Staff in talking about a service user said “it took a long time for her to get to know and trust us and let us support her”. This service user prefers not to discuss things with the inspector, however during this inspection she felt able to ask me to turn the television on. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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) 12, 13, 14, 15, Service users view the home very much as their home, where they are able to exercise choice and enjoy meeting friends and relatives. EVIDENCE: Service users visitors are made welcome. A service user said that their relative comes in the evening. A service user and their relative discussed how they can “come in whenever”, are offered drinks and the service user goes to stay with their relative. One service user “sets the table up” for meals, which they expressed as their job and that in terms of cleaning their room, stated staff “tidy everything up for me”. There is a daily activity planned in the home including bingo, quizzes and ball throwing. Service users all commented that a favourite was a sing along, a poster advertised ‘keyboard magic’ as the next planned session. Staff were heard to sing with service users while they were assisting them. Service users spoke of how they were able to make choices including choosing “beans on toast” as an alternative that day for tea. Choices were confirmed by comments such as “we have decided to go to Hastings for a day out”, “we can go to bed when we like”, and a relative commented that “…..takes herself to bed”. A group of service users said that they liked having cups of tea agreeing with one service user who stated they have “plenty of cups of tea”. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 13 Service users private rooms were suited to individual taste, some having brought in personal furniture. A service user spoke of how she “got on well with everyone”, and when another service user who was her friend was unwell she sat with her, keeping her company. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18, Service users feel safe and able to complain. EVIDENCE: There has been no need for any adult protection alerts to be raised. Adult protection training from KCTA has been provided for staff. Service users rooms seen had lockable facilities. A service user who chose not to lock her door said that she “didn’t want a lock on the door” as she felt that her things were safe. Service users spoken with had no complaints and felt that if they did they would tell the staff. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 15 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, 20, 21, 22, 24, 26. Service users live in a comfortable well-maintained environment. Service users are able to furnish and decorate their personal rooms to their own taste. EVIDENCE: Those service users rooms seen were individual and had plenty of personal effects. One room had been decorated to suit the taste of the service user who chose to purchase her own bed. The manager said that another room was going to be redecorated by the service users family to individual taste and that the home was going to replace the curtains. The garden area was very pretty and well maintained with seating provided for service users. A carpet cleaner has been purchased. One of the service users rooms has been fitted with an automatic door closing devise so that their door can remain open but be safe in the event of fire. The service user told the inspector that they preferred their door open as they were ‘claustrophobic’ and now they did not need to wedge it open. One service user had their feet elevated on a footstool. The manager showed the inspector a copy of an invoice for 6 Queen Ann footstalls and 6 standard over bed tables. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 16 The manager stated that the home have resubmitted planning permission for improvements, plans have been received by the CSCI. A format recording items as listed in standard 24.2 was seen completed in a service users file. A call bell was tested and staff responded very quickly. The manager stated that they were in the process of looking for suitable pictorial engaged/vacant indicators for the bathrooms so they can be easily recognised. The manager informed the inspector that she has contacted the occupational therapy department who have stated that they are unable to undertake assessments on private care homes. The manager stated that when equipment is needed such as footstools; an over the toilet frame that is fixed or the automatic door closing devise that she searches for the most suitable equipment and seeks advice from the companies as to suitability. If service users require any specialist equipment the manager stated that she would seek an occupational therapist’s advice on an individual basis. Advice given by the local social services occupational therapy bureau is that, private care homes are directed to seek a qualified private OT facility through the, College of Occupational Therapists, 106 – 114 Borough High Street, Southwark, London, SE1 1LB, telephone, 02073576480. It was recommended during the last inspection that the home review their policies and procedures in the use of one sink in the sluice/laundry room and soiled laundry with appropriate advice sought i.e. infection control. The inspector was shown a report from the environmental health officer who visited in February and inspected the kitchen. Minor recommendations had been made which the manager had either completed or had plans to do so i.e. food hygiene training which had been booked. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 17 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, 30, Service users have a small regular staff team who offer a good quality of individual support. EVIDENCE: The manager works as part of the care team, having some days as supernumerary to catch up on the administration. Service users commented how nice the staff are, a relative who stated staff are “very, very nice” echoed this. During the inspection the manager was on a training day, although she did come to the home when this had ended. There were two staff on duty. One extra staff member had stayed on for the afternoon as a member of staff was escorting a service user to a medical appointment. The home has a one waking and one sleep in staff at night. The manager is a full paid member of the National Care Homes Association. Training for staff has included care planning; fire prevention; food hygiene foundation training and first aid. The home have training provided by KCTA, a matrix of mandatory training offered by KCTA was seen and contained a list of dates and staff names who have been booked a place. Two staff have nearly completed the NVQ level 2 award, one person had commenced the NVQ level 3, however the company ceased and the manager is currently seeking another. Staff on duty were very familiar with the service users needs and were seen to anticipate and offer the support that the service users needed. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 18 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, 37, 38, Service users can feel confident that they are receiving a service that is managed professionally from a competent experienced manager, who places a high regard to their safety and that of staff. EVIDENCE: The manager is doing the registered managers award course NVQ level 4, she has the CMS certificate, is a qualified nurse, obtained the vocational assessors award in June 1994, has obtained the BTEC continuing education certificate and a certificate in personal practice. A relative detailed how they act as appointee for a service user. The home does not manage service users money. Service users spoken with confirmed that relatives managed their finances. Lockable storage facilities were seen in service users rooms. The service users files and records were kept locked either in the dining room or in the office. Records seen were dated and signed. A service user spoken with was unfamiliar with their records although they had signed their care plan, they did state that their family sorts things out for them. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 19 The Environmental Health Officer has visited and inspected the kitchen in February 2005. The inspector was informed when the boiler broke down and records were seen that were kept of water temperatures. Overall the home was found to be very clean, tidy and well kept. A frame over the toilet had been fixed, another frame had not, the manager said they were considering whether the toilet needed replacing and what would best suit the service users. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 20 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 3 3 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 2 2 x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 x 3 3 Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 21 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 Regulation Requirement Timescale for action 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. 2. 3. Refer to Standard OP 7 OP 8 OP 21 Good Practice Recommendations It is recommended that forward planning is made for annual reviews to identify when reviews are due. It is recommended that the home provide equipment necessary for the promotion of tissue viability and prevention of pressure sores. It is recommended that the toilets for service users be clearly marked. It was not inspected on this occasion if the bath which was identified during the last inspection as not in use was adapted to provide a shower facility or other arrangements made for it so that it is suitable for the current service uses. It is recommended that an assessment of the premises and facilities are made by suitably qualified persons, including a qualified occupational therapist. It is recommended that sufficient tables and footstools as are necessary are made available for servuce users in the lounge. It is recommended that the home review their policies and procedures in the use of one sink in the sluice/laundry room for soiled laundry with appropriate advice sought i.e. H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 22 4. 5. 6. OP 22 OP 22 OP 26 Ashton Lodge 7. OP 38 enviornmental health. It is recommended that a standing frame over the toilet seat be fixed to the floor or replaced. Ashton Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Lodge H56-H06 S23889 Ashton Lodge V219225 240505 Stage 4.doc Version 1.30 Page 24 - 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. 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