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Inspection on 06/02/09 for Ashton Lodge
Also see our care home review for Ashton Lodge for more information
This inspection was carried out on 6th February 2009.
CSCI found this care home to be providing an Good service.
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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.
Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Ashton Lodge 3 Daneshill Road Leicester LE3 6AN The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Fiona Stephenson
Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home
Name of care home: Address: Ashton Lodge 3 Daneshill Road Leicester LE3 6AN 01162620075 01162620075T/F vimiseewooruthun@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Ramesh Dhunjaysingh Seewooruthun care home 27 Number of places (if applicable): Under 65 Over 65 0 0 27 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 27 27 0 27 The maximum number of service users who can be accommodated is 27. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Mental disorder, excluding learning disability or dementia - Code MD. Old age, not falling within any other category - Code OP. Physical disability - Code PD. Dementia - Code DE Date of last inspection Brief description of the care home Ashton Lodge Residential Home is a care home offering accommodation for up to twenty-seven older people. People who come to live at Ashton Lodge may have dementia and/or mental disorder, and/or they may be physically disabled. The home is located near to the centre of Leicester. There are bus routes, which pass near to the Care Homes for Older People
Page 4 of 25 Brief description of the care home home. The home itself is situated in a residential area. Ashton Lodge is a large Victorian property, which has been converted and extended. It has a large rear garden, which is well maintained. Accommodation is provided on the ground and first floors. There are fifteen single and six shared bedrooms. Bedrooms are located on both floors. All areas on the first floor are accessible via a slow moving lift. Residents have use of a number of lounges and communal spaces. Care Homes for Older People Page 5 of 25 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CSCI) visited Ashton Lodge on Friday 6th February 2009. We were there from 8.55am until 4.20pm, and were helped by the two deputy managers, staff and people who live at the home. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, talking to the people who live at Ashton Lodge, talking to staff and management, Care Homes for Older People
Page 6 of 25 watching how people are being given support, looking at records. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the Provider (the person who owns the service) sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at Ashton Lodge. We spoke with both deputy managers on duty at the time of the visit, and observed and spoke with staff and people who live at Ashton Lodge. We also looked at the 13 responses we received from the Have your Say questionnaire sent to people who live at the home, and their relatives. All gave positive feedback about the service. One relative said It does everything possible to address my mothers needs. Another said they treat the people there with care and dignity and always with a smile. The 11 people who live at the home who completed the questionnaire all felt they were given good care and were able to go and talk to management and staff if they were unsure or unhappy about anything. Most felt there were enough activities in the home, and all felt the home was clean and tidy. We checked all the standards that the CSCI has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to respect their confidences. What the care home does well: What has improved since the last inspection? What they could do better: Management should continue to improve care planning to meet the emotional and social needs of people living at Ashton Lodge. Management should consider the introduction of fruit juice on the menu to support the nutrition of people living at Ashton Lodge. The provider should consider changing the ground floor bathroom which is not used because it is difficult for people to use the bath safely, into a shower room. The bedroom furnishings and decor could be improved. Management have recognised this, and it is planned to improve these areas once the redecoration of the communal Care Homes for Older People Page 8 of 25 areas is complete. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Ashton Lodge have adequate information to help them make their decision. Evidence: There have been no new admissions to Ashton Lodge since the last key inspection in October 2008. We were told by management that people who are thinking of moving to Ashton Lodge have the opportunity to visit the home and talk to people who live there and the staff who support them before they make a final decision to move into the home. We looked at the Statement of Purpose, this is a document which tells people what service people can expect at the home. We found that the Statement of Purpose had been up dated since the last inspection, but still didnt fully explain how the service intends to support people with mental health problems, alongside those with dementia
Care Homes for Older People Page 11 of 25 Evidence: and old age. Management at Ashton Lodge use the assessment of need undertaken by Social Services before a person moves into the home to help them develop a care plan for each person living at Ashton Lodge. Care Homes for Older People Page 12 of 25 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ashton Lodge have their health and personal care needs well met. Evidence: We looked at the care plans of three people who live at Ashton lodge. We saw that these gave good information about the care needs of people living in the home, in particular, the health and personal care notes showed that very good health and personal care had been provided to the people we case tracked. We saw that the service is getting more information about the personal histories of people who live at Ashton Lodge, and about their social and emotional needs but this is not as well documented as the health and personal care needs. We looked at the medication notes, and we watched staff give people who live at Ashton Lodge the medicines prescribed by their GP. We saw that the medication was given safely, with good hygienic practice observed during this time. We watched how staff talk to, and support people who live at Ashton Lodge. We saw
Care Homes for Older People Page 13 of 25 Evidence: that staff treated people who live in the home with dignity and respect. Care Homes for Older People Page 14 of 25 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have adequate opportunities to undertake social activities. Evidence: We looked at the written information about activities people do at Ashton Lodge, and saw that there are some planned activities that are provided each week. We saw that staff are getting to know more about the activities people like to do, but this information has yet to be used effectively to plan activities that meet the needs of each individual. Whilst we were there, we saw staff have a game of skittles with two of the people who live at Ashton Lodge. We saw also, that the TV was on during the afternoon with noone watching it. We saw that in the same lounge there was a music system which was not being used. We were told by staff and people who live in the home that they can see their friends and family when they wish to. We saw the new four week menu which has recently been introduced, and thought
Care Homes for Older People Page 15 of 25 Evidence: that it provided a good nutritional balance for people living at Ashton Lodge. We were told that people living at Ashton Lodge have the choice of a range of cereals for breakfast, or toast with jam, or porridge. A cooked breakfast is provided for those who wish it, at the week-end. We were told that fruit juice is not provided at breakfast. We watched the main meal being served at lunchtime. On the day of our visit (Friday), the cook had prepared fish, chips and mushy peas, with stewed apples and custard for pudding. People living at Ashton Lodge were seen to enjoy their meal. We saw that people who needed support in eating their meal were give one to one support. We saw that people were not waiting a long time before the meal was served up, and the dinner time experience had vastly improved since the last time we visited. We saw people who needed help with moving, being supported well with equipment to help them move safely. We saw that people who live in the home feel able to tell staff and management how they feel, and those views are respected. Care Homes for Older People Page 16 of 25 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ashton Lodge are well supported and protected by management and staff. Evidence: We saw the complaints record held at Ashton Lodge, which showed that complaints have been taken seriously and were dealt with quickly and effectively. There have been no complaints made to the CSCI about any aspect of the service provided at Ashton Lodge. Management and staff have a good understanding of how to safeguard people who live at Ashton Lodge from abuse. Staff know to inform the manager if they have any concerns about the behaviour of other staff or residents that may be impacting on the safety of people who live in the home. We checked staff recruitment records and were satisfied that the manager has ensured all the necessary checks which were not in place at the last inspection, have now been carried out. Care Homes for Older People Page 17 of 25 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ashton Lodge live in a satisfactory but improving environment. Evidence: On arrival at Ashton Lodge we saw the home was undergoing re-decoration. The communal areas were being re-decorated, and we were informed that this was the beginning of a process to improve all areas of the home. We saw that the dining room and front lounge had already benefited from some of the redecoration in the home. We looked at the bedrooms of the three people we case tracked. The decor was satisfactory, but the furniture in all rooms was worn. We were informed by management that part of the plan was to upgrade the furniture once the rooms had been re-decorated. All areas of the home were clean and tidy, although one of the rooms had an unpleasant smell. We looked at the communal bathroom facilities and found these to be clean. We were told that one of the bathrooms is not used because the position of the bath makes it difficult to safely support people getting in and out of the bath. Care Homes for Older People Page 18 of 25 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal care needs of people living at Ashton Lodge are well supported by the skills of staff working at the home, and the staffing levels. Evidence: We watched to see whether there were enough staff on duty to meet the needs of people living at Ashton Lodge, and saw that there were enough staff to support residents during quiet and busy times of the day. We were told by management that since the last inspection, staff lunch breaks had been changed to ensure there were enough staff on duty during busy periods of the day to help support people when eating their food, and in giving medication out safely. We also looked at the staff rota for the day time and evening, and were satisfied that there were enough care and support staff on duty at all times of the day and night to provide good care to people who live at Ashton Lodge. We looked at the staff records and saw that the proper checks on staff are now in place before staff can work with people who live at Ashton Lodge. We looked at staff training records, and talked to staff about the training and support they get at Ashton Lodge, and saw that people receive good training to enable them to do their work effectively and safely.
Care Homes for Older People Page 19 of 25 Care Homes for Older People Page 20 of 25 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ashton Lodge is well managed. Evidence: The registered manager has many years experience of managing a care home, and his deputy managers are well qualified and competent to do so. We saw by looking at the records, by talking to management and staff, that the management of the home has improved since the last visit. The deputy managers have a clear understanding of their roles and responsibilities, and have given some management responsibilities to other senior staff. We saw that staff are given regular supervision and support to help them undertake their duties, and staff meetings are held for both night and day staff. We saw that there is now a system in place for feedback from people who live at the home, and relatives and professionals who visit the home to enable management to find out what they can improve, and what people think they do well. We saw by looking at feedback already received from relatives, residents and health care
Care Homes for Older People Page 21 of 25 Evidence: professionals that the service is held in good regard by those who live there and visit it. Management now has a development plan which shows how it intends to improve the service to people who live in the home, the focus of which is currently to improve the environment for people who live at Ashton Lodge. We checked the personal finances of people who live at Ashton Lodge and found there to be good procedures in place to make sure monies are kept safe. During our visit we saw that staff were ensuring that the health and safety of people living at Ashton Lodge was well attended to. This was observed in the moving of residents, in infection control practice when doing the laundry, in fire safety, and in ensuring that residents are kept safe during the time that decorators were in the communal areas. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 1 The provider should further update the statement of purpose to explain more fully how the service intends to support the range of people it is registered to care for. The provider should continue to improve activity planning for each person who lives at Ashton Lodge. The provider should consider improving the nutrition of people living at Ashton Lodge by introducing fruit juice as a choice of drink during the day. The provider should consider changing the bathroom on the ground floor into a more user friendly shower room. 2 3 12 15 4 21 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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!