Inspection on 22/05/06 for Ashtonleigh

This inspection was carried out on 22nd May 2006.

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

Ashtonleigh 25/10/05

Ashtonleigh 21/06/05

Ashtonleigh 11/11/04

Ashtonleigh 17/06/04

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 Ashtonleigh 4 Wimblehurst Road Horsham West Sussex RH12 2ED Lead Inspector Mrs V Gay Unannounced Inspection 22 May 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 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. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ashtonleigh Address 4 Wimblehurst Road Horsham West Sussex RH12 2ED 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) 01403 259217 Ashtonleigh Residential Care Home Limited Nicola Ambler Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2005 Brief Description of the Service: Ashtonleigh is a care home registered to provide personal care for up to thirty older people. The home is a converted large detached house on the outskirts of the town of Horsham. It has large enclosed gardens to the rear and a parking area at the front and side. It is in a residential area of the town. The accommodation is provided in twenty single rooms and four double rooms. Eighteen of the bedrooms have en-suite facilities. These are on two floors of the property with the upper floor being serviced by a passenger lift. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over five hours including a review of events at the home since the last inspection. There have been no complaints made about the home and no concerns raised regarding care of residents since the previous inspection. On the day of the inspection a tour of the premises was made, discussions were held with several of the residents at the home as well as the manager, visitors and staff. In addition, the inspector interviewed three staff and case tracked four residents to ensure their individual needs were being met. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents at Ashtonleigh are being taken care of. At this inspection the Inspector looked at core standards, as well as any outstanding issues from the last report. Previous requirements checked for compliance were met. One requirement was made during this inspection in respect of the Registered Provider’s monthly reports. Residents spoke highly of the home saying the staff were kind, attentive and caring. Overall quality of the home is good. This judgement was made using available evidence, including a visit to this service. During this inspection, the Registered Manager Mrs. Nicky Ambler and her senior carer assisted the inspector. The inspector would like to thank both them, and everyone else who cooperated with her at this inspection. What the service does well: What has improved since the last inspection? Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 6 Since the previous inspection the Registered provider has installed nine electronic door closures to enable residents to have their bedroom doors open, without compromising the fire safety standards of the home. A security pad has been installed to the cellar door to ensure it remains closed at all times. This area is used as the laundry and is not safe for the residents to enter due to the very steep steps 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. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 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 Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 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 the following standard(s): 3,6 No resident moves into the home without having his/her needs assessed first. Intermediate care is not being provided at Astonleigh. Quality in this area is good. This judgement was made using available evidence including a visit to this service. EVIDENCE: This standard was met at the previous inspection so the inspector checked for compliance only. Assessments were examined and care plans case tracked. These were found to be a true reflection of the resident and information included emotional and social interests. The assessment format included the necessary information as stated in Schedule 3 and 17 (2) of the Care Regulations. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7,8,9,10 Residents health, personal and social care needs are set out in individual careplans Residents can make their own decisions about how they wish to spend their time. Medication procedures in the home are being well managed. Residents feel they are treated with respect and their rights and privacy are up held. Quality in this area is good. This judgement was made using available evidence including a visit to this service. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 10 EVIDENCE: Four service users files were examined, including a recently admitted resident. Daily care needs together with risk assessments of the environment were in place. The staff have access to each residents plan, and make daily entries after each shift to ensure a continuity of care is provided. The plan is reviewed by the Registered Manager monthly or as needs dictates. GP visits are recorded and District Nurses support is documented. The social and recreational interests of residents are recorded. Residents said the home met their varying needs and that the staff were attentive and kind. Residents said they could spend their day as they wish with, no pressures placed upon them. One resident told the inspector that she did not wish to engage in social activities and that her wishes were respected. Four visitors also confirmed that they were very satisfied with the standards of care the home provided. Comments included Staff are so kind whenever we visit nothing is too much trouble you only have to ask. Medication is safely stored and suitably recorded. Residents said their privacy and dignity was respected, and staff were seen to address resident in a respectful manner during the inspection. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12,13,14,15, Emotional and social care needs of the residents are met The routines in the home are flexible and meet with the service users wishes. The service users have contact with their families and friends. The meals are varied, well balanced and served at times convenient to the residents. Quality in this area is good. This judgement was made using available evidence including a visit to this service. EVIDENCE: Residents said that the home met their expectations, although two residents said they missed living in their own homes. During the inspection several visitors were present and from observations made it was obvious that they enjoyed a good relationship with the staff. Visitors told the inspector that they thought the home was a good place and they had no adverse comments to make. One relative said she visited daily and was always made to feel welcome by the staff. An activity organiser is employed on a sessional basis three times a week to broaden the scope of in-house activities for the residents. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 12 Residents said the programme included Bingo, Musical exercises and Quizzes. A hairdresser also visits to attend to the needs of the residents. Many residents made comments about the quality of the food. They said mealtimes were enjoyable; the food was well cooked and plentiful. The Inspector joined the residents for lunch, which is served in two setting. This is due to the size of the dining room, and also because the first setting is used to assist those residents who require more help with feeding. The meal was appetising, hot and served in a way that encourages a resident to want to eat. Alternatives were available, and it was obvious that the cook consults daily with residents and knows their likes and dislikes . Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16,18 Residents and their relatives are confident that their complaints will be listened to, and taken seriously as stated in the Service Users Guide. Robust recruitment practices are being followed to ensure the right kind of people are being employed to care for vulnerable persons. Quality in this area is good. This judgement was made using available evidence including a visit to this service. EVIDENCE: The complaints record evidenced that complaints are taken seriously and responded to within the given timescales. The Registered manager was able to demonstrate a sound understanding in respect of (POVA) Protection of Vulnerable Adults and how to respond to staff Whistle Blowing. No complaints had been received since the previous inspection. The majority of the residents have the benefits of families or friends who visit the home. Staff files were examined as part of the case tracking process. All contained the necessary documentation as required by Schedule 4, Regulation 17 (2) of The Care Regulations 2000. Criminal record Bureau checks are carried out prior to any member of staff working in the home. The home has no dealings with the resident’s financial affairs. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19,26 Residents live in a safe, well-maintained environment. Standards of hygiene and cleanliness throughout the home are good. Quality in this area is good. This judgement was made using available evidence including a visit to this service. EVIDENCE: A tour of the home revealed attractively presented accommodation that was well proportioned, clean and fresh. There is a large secure garden leading from the lounge area, which residents said they made good use of in the summer months. The home is suitably equipped with aids and adaptations to promote residents independence and assist with their mobility requirements. A laundry assistant is employed to ensure residents clothing is laundered to a good standard. Bathroom and toilets were clean and contained hand washing facilities and paper towels. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 15 Since the previous inspection fire door closures have been installed to those residents rooms that choose to have their doors open. This complies with the fire safety standards and ensures fire safety in the home is not compromised by wedging doors open as was the practice in the past A safety pad closure has been installed to a cellar door to ensure the door remains closed at all times. This is to prevent a residents falling down the steep flight of stairs. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Adequate staffing is provided to meet the needs of residents. Residents are in safe hands at all times. The Registered Provider operates a thorough recruitment procedure to ensure the right types of people are employed. Staff have the necessary skills and knowledge to perform their duties. Quality in this area is good. This judgement was made using available evidence including a visit to this service. EVIDENCE: The inspector saw the duty board and asked residents if there were sufficient staff for the help and support they needed. They confirmed that staff were always available and one said “she was looking forward to having her daily bath which required the help of two staff. A cook, cleaner and housekeeper are employed and were on duty at the time of the inspection. Records and discussion with residents and staff showed that there was a nucleus of long serving staff that knew the residents needs and wishes very well. Three staff files were examined; this included a new member of staff who was starting her induction that day. They contained the necessary documentation required by Schedule 4 and Regulation 17 (2) of the Care Homes Regulations. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 17 The home is well on its way to achieving 50 of its care staff trained to National Vocational Qualification level 2 or 3. Three staff interviewed said they felt well supported by the manager, and that training courses and induction training are provided. Records evidenced that staff on duty were competent and trained to carry out their duties. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 The Registered Manager is a qualified registered nurse with several years experience in caring for the elderly. She is currently involved in training leading to a qualification in National Qualification level 4 Care Management Records needed for the safe running of a care home are kept up to date, apart from monthly reports of visits carried out by the Registered Provider. A requirement has been made to this effect. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at Ashtonleigh. Residents are safeguarded by the accounting and financial procedures of the home. Staff members are appropriately supervised. Resident’s rights and best interests are protected, by the home’s record keeping and policies and procedures. Quality in this area is good. This judgement was made using available evidence including a visit to this service. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 19 EVIDENCE: From the information received from staff and residents it would seem that the Registered Manager ensures the management approach of the home creates and open, positive and inclusive atmosphere. Staff told the inspector that they felt involved in the daily running of the home and that they worked well together as a team. Although the inspector was informed that the Registered Provider regularly visits the home and consults with residents, reports of his findings as required by Regulation 26 reports were overdue. The last report in the home was made in September 2005. A requirement has therefore been made to this effect. Staff received supervision and two monthly appraisals to ensure they have the necessary skills and knowledge to perform the tasks required of them. Staff meetings and residents meetings are held to encourage feed back as part of the Quality Assurance Procedure. Relatives meetings have been organised for June 2006 and results from these meetings will be inspected at the next inspection. The accident register was examined and the Registered Manager confirmed regular audits are carried out as part of good practice. The health, safety and welfare of residents and staff are promoted and protected by the policies and procedures in place. Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 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 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 3 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 3 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 2 X 3 X 3 3 X 3 Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 21 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 OP31 Regulation 26 Requirement Where the Registered Provider is not in day-to-day control of the home, he shall visit the home in accordance with this regulation. A written monthly report on the conduct of the home must be available for inspection. Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Ashtonleigh DS0000014377.V289610.R01.S.doc Version 5.1 Page 23 - 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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