Inspection on 09/01/07 for Ashton Manor Nursing and Care Home

This inspection was carried out on 9th January 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

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 Manor Nursing and Care Home Ashton Manor Nursing and Care Home Beales Lane Farnham Surrey GU10 4PY Lead Inspector Mavis Clahar Key Unannounced Inspection 9th January 2007 09:40a 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 Manor Nursing and Care Home DS0000067977.V325448.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 Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton Manor Nursing and Care Home Address Ashton Manor Nursing and Care Home Beales Lane Farnham Surrey GU10 4PY 01252 722967 01252 713180 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) Ashton Manor Care Home Ltd Linda Wass Care Home 39 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (39), Terminally ill (6) of places Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Aston Manor is a large Victorian house situation in the village of Wrecclesham, near Farnham in Surrey. It provides nursing care for up to 39 older people. Accommodation consists of single and shared occupancy rooms, all of which are en-suite. Communal areas include a lounge, a separate dining area and a large conservatory. The garden is laid mainly to lawn and is situated to the rear of the property. There is adequate car parking to the front of the property. Fees at this home are within the range of £625 to £750 per week. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the home’s first key inspection to be undertaken by the Commission for Social Care Inspection (CSCI) was undertaken by Mrs Mavis Clahar on the 9th January 2007 and lasted for six hours and fifty minutes; commencing at 09:40 hours and concluding at 16:30 hours. The first part of the inspection was spent discussing the inspection process with the deputy manager, followed by time spent observing the registered nurse administering medication to service users. This was followed by a tour of the home which included time spent in discussion with service users, care workers and the Chef. The home has recently changed ownership and staff and service users were enthusiastic about the changes such as management style, running of the home, availability of courses and the upgrading of service users bedrooms the new owner has instigated. CSCI received a number of completed questionnaires from relatives and professionals visiting the home and they all commented on the high standard of care their relatives receive and the friendliness and approachability of the staff. One reported on the apparent lack of activities for the service user and the service users supported this during the inspection. In discussion with service users some requested keys for their bedroom doors. A recommendation of good practice was issued regarding the availability of keys to service users for their bedroom doors. All records sampled were up to date with care plans being signed by the service users or by relatives. One requirement regarding regular provision of suitable activities for service users was issued on this visit The inspector would like to thank all the service users, care staff and chef who made the visit so productive and pleasant on the day. Thanks also to all the relatives who took time to complete the Commission for Social Care Inspection (CSCI) questionnaire your views on the home are highly valued. What the service does well: Service users spoke highly of the care and support provided by the home; they said, “We love our home”. Comments included in the response of the CSCI questionnaire stated that the care workers always made visitors and relatives feel welcome and service users spoken to confirmed that their relatives were treated well by the whole team. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 6 The home has, since the 1st January 2007 commenced using the Spandex system, which is a method of recording the assessment of health and social needs of the service users, and to plan their care. Staff questioned said this is a better system than the computerised notes they were using prior to this change. The home has demonstrated its capability to cater for service users from ethnic minority whose assessed needs are identified, documented and met. The home does not have an Equality and Diversity policy, but they do have an equal opportunities policy, which they use in selecting inducting and preparing carers from overseas to work within the British culture. 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. 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 Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3.6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed prior to admission to the home by skilled and competent staff, in order to assure that their needs will be met. Intermediate care is not provided in the service and therefore standard six does not apply. EVIDENCE: Good information was obtained from prospective service users prior to their admission into the home. Where the assessments have been undertaken through care management arrangements the manager insists on receiving a copy of the care plan. This allowed for care workers and service users to make informed decisions regarding the planning and delivery of care. Skilled and competent staff at the home carries out all other pre admission assessments. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 9 Random sampling of service users files, care plans and daily work sheet, and along with selected case tracking has demonstrated the homes ability to assess service users needs. This was supported by discussions with the deputy manager, the key worker and the service user themselves. Discussions with care workers have shown that they have the knowledge suitable to meet the care needs of the service users in their care. The inspector was informed that service users cultural needs are taken into consideration during the assessment process to ensure the home would be able to meet their needs fully. Ashton Manor Nursing and Care Home DS0000067977.V325448.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 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good and clear care plan in place for each service user, which also includes appropriate risks assessments and demonstrated that health and personal care needs were met. The home’s medication policy on receiving, storing and administering and return of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers are aware of the need to treat service users with respect and to maintain their dignity and privacy when delivering personal care. EVIDENCE: The randomly selected care plans reviewed, were clear and easy to read, identifying risks to service users. The daily work sheet along with discussion Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 11 with service users demonstrated that service users care needs are met according to the agreed plan of care. The inspector observed the administration of medicines to service users in accordance to the homes policy on administration of medicines, the Medicines Act 1968 and the Nursing and Midwifery Council (NMC) Standards for administration of medicines. One service user at the time of inspection was responsible for their medication and there was suitable risk assessment in place for this service user. Good clear records are kept of medication received, stored and returned. A list of care workers trained and assessed as competent to administer medication was available for review. Service users spoken to on the day of the inspection rated the personal care they receive at the home as very good. Service users unanimously said, “We are treated with respect”. They said the staff team are friendly and that there has been a lot of improvement in the running of the home since the new owner has taken over. Two service users spoken to requested keys to their bedrooms and this was discussed with the deputy manager, who was unaware of the wishes of these service users. The deputy manager informed the inspector that regular discussions are held with service users to identify their needs and then the home take reasonable action to meet them. This was also said to be a focus during supervision with staff. Ashton Manor Nursing and Care Home DS0000067977.V325448.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 13 14 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lifestyles do not match their needs and preferences. However, where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: Care workers were observed interacting favourable with service users. Service users spoken to said they were bored, and that there are not enough activities available. The home does not have an activities co-ordinator in post. Service users said “Pat The Dog comes once per week and the staff provides activity in the afternoon, but this is not enough”. The inspector observed many service users sitting in the lounge, watching television or snoozing. A requirement was made that this aspect of care be improved. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 13 Service users said they are able to make choices and exercise control over their care. This was reflected in the care plans, which were signed by the service users to show they were consulted about their care needs. However, they said they had no choice about going out, and they miss being able to have the occasional day away from the home. The inspector did not sample the food, but the service users said the food is good, and plentiful. In discussion with the Chef, it was apparent he was knowledgeable about the dietary needs of the service users and prepared their food to their tastes. The Chef operates from a four-week menu. There is a choice of two hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelette etc. The evening meal is always soup followed by hot meal or sandwiches filled with service users choice. There were ample amount of fresh fruit, dry food and frozen food available in the home. Ashton Manor Nursing and Care Home DS0000067977.V325448.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adult’s policies are in place to protect the service users from abuse and care workers work to protect service users. EVIDENCE: Complaints received at the home are logged with their outcomes. This demonstrated that service users and relatives complaints are taken seriously and are dealt with within the company’s time frame. Service users spoken to said they knew how to complain if there was a need to do so. Random sampling of staff training files and discussion with staff evidenced that staff are being trained to recognise and report any act or suspicion of abuse to service users. The deputy manager supported this by the production of the staff training matrix which evidenced that staff receive yearly training in the safeguarding of adults (protection of vulnerable adults) to remind them of their duty of care to the service users living at the home. The Provider informed the inspector that the management of the home is based on promoting policies and actions to prevent bullying and harassment of service users and staff Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 15 within the home, thereby working within the law as it relates to equality and diversity. Ashton Manor Nursing and Care Home DS0000067977.V325448.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained, clean and safe environment, which provides aids and equipment to meet the care needs of the service users EVIDENCE: The home operates within its planned programme of refurbishment and maintenance. The deputy manager stated that bedrooms are redecorated as soon as they become vacant, and some service users are moved into vacant bedrooms whilst their bedrooms are being decorated. A relative in the questionnaire returned to CSCI supported this statement. The home presents as comfortable with good ventilation. There is good wheel chair and pedestrian access to the garden, which is laid mainly to lawn with seating available. One service user said, “I try to go out as much as possible weather permitting. We tend to use the garden mostly when the weather is good. Not too hot”. It was observed that service users were able to Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 17 personalise their bedrooms with small items of furniture, paintings hanging on the wall and many family photographs. On the day of the inspection the home was clean and free from offensive odours. Rooms appeared well ventilated and service users said they were kept warm in the home. It was noted that service users were appropriately dressed for the time of year. Ashton Manor Nursing and Care Home DS0000067977.V325448.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 28 29 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained, skilled and competent staff were on duty in sufficient numbers to meet the service users needs. The service recruitment policy is adequate and supports and protects the safety of service users Care workers are trained and competent to do their jobs. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was adequate to meet the assessed care needs of the service users. A number of care workers have attained the National Vocational Qualification (NVQ) Level 2 qualification. The registered manager is in possession of the Registered Managers Award (RMA). Review of care workers files demonstrated that care workers had regular and up to date training to enable them to fulfil their roles. A random review of care workers files found that the home complied with the regulation regarding employment of staff to work in care homes. Records contained evidence that care workers attended all training offered. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 19 Recruitment to the home is through a process of equal opportunity, and in accordance with the code of conduct and practice set by the General Social Care Council (GSCC). All care workers have Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and they are in receipt of terms and conditions of employment as evidenced in their randomly selected files. There was evidence in the care workers files that they are supervised on a regular basis. All newly appointed care workers undertake an induction programme, and this was supported during discussions with a new member of staff. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the deputy manager and care workers and by checking care workers’ training files. Ashton Manor Nursing and Care Home DS0000067977.V325448.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home and works to continuously improve services and seeking the views of service users and their relatives in the running of the home. Service users financial interests are safeguarded and the health and safety of service users is promoted and protected EVIDENCE: The training records of the registered manager has demonstrated that she has kept herself updated on issues relating to care of service users and staff in her charge. She has acquired the Registered Managers Award (NVQ L4) in management, and is a Registered General Nurse with many years experience Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 21 of nursing and management. In discussion with the deputy manager and care workers, it was evident the manager was knowledgeable about the care needs of the service users and the training needs of the care workers to meet the identified care needs of the service users. There are clear lines of accountability within the home; each member of staff spoken to on the day of the inspection was clear about their role and responsibilities. The home does not become involved in service users’ finance. This is left with the relatives and representatives of individuals. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training was carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers, they demonstrated they had an understanding of the implementation of appropriate procedures to safeguard service users, and they spoke about their understanding of promoting safe working practices based on their health and safety training. Ashton Manor Nursing and Care Home DS0000067977.V325448.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 X 3 X x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 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 3 X 3 X 3 X X 3 Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? New Service 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 OP12 Regulation 16 (2) (m) (n) Requirement The registered person(s) must ensure that a variety of suitable and stimulating activities be available for all service users including those with mental frailty. Timescale for action 09/04/07 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 OP10 Good Practice Recommendations The registered person must ensure that those service users who request a key to their bedroom doors be offered one. Ashton Manor Nursing and Care Home DS0000067977.V325448.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Manor Nursing and Care Home DS0000067977.V325448.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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