Inspection on 25/09/08 for Ashurst

This inspection was carried out on 25th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashurst 26/03/08

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

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Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashurst 36 - 38 Westbourne Park Scarborough North Yorkshire YO12 4AT     The quality rating for this care home is:   one star adequate 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: Pauline ORourke     Date: 2 5 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ashurst 36 - 38 Westbourne Park Scarborough North Yorkshire YO12 4AT 01723360392 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Monami Care (Scarborough) Limited Type of registration: Number of places registered: care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 19 The registered person 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 to the home are within the following category: Old age, not falling within any other category - Code OP. Date of last inspection Brief description of the care home Ashurst is registered to provide accommodation and personal care for nineteen older people. Ashurst is a detached property and is located in a central area of Scarborough. The home is conveniently located for all main community facilities including the public transport network. Restricted on-street parking is available. The property consists of four floors with the accommodation for people who live in the home being located on the ground, first and second floors. The home has a small passenger lift. There are Care Homes for Older People Page 4 of 27 Over 65 19 0 Brief description of the care home three double bedrooms although currently one double is being used as single accommodation. None of the bedrooms have en suite facilities. The care home has a small front seating area and rear garden. Care Homes for Older People Page 5 of 27 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: one star adequate 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: The Commission of Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one -off events. information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk The key inspection has used information from different sources to provide evidence for this report. These sources include: - information provided by the registered person on an Annual Quality Assurance Assessment. Care Homes for Older People Page 6 of 27 - A visit to the home by one inspector that lasted for eight and a half hours. -Information gathered at a random inspection carried out on the 1st July 2008. During the visit to the home eight people who live there, and three members of staff were spoken with. Care records relating to four people, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Ashurst for people living there. The assistant manager was available to assist throughout the visit and was available for feedback at the close. On 26th March 2008 the assistant manager confirmed that the fees range from 329.50 pounds to 359.50 pounds a week. In addition to this people pay for their own toiletries and the hairdresser. What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Care Homes for Older People Page 9 of 27 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 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have up to date information about the home prior to moving in. People can choose to move into the home knowing the help they need has been identified and staff have the skills to provide the help they require. Evidence: The Statement of Purpose and Service User Guide provided to people thinking about moving in to the home have been updated to show that new owners are in place. The Statement of Purpose has been updated and includes the complaints procedure and clear information about the people they can provide a service to. This document could be further improved by clearly specifying that the servcie is not discriminatory and does not exclude anyone on the grounds of race, gender, sexual orientation or faith. Four case files were seen and each of them contained an assessment of need. This information had been provided either by a care manager or by the assistant manager. Care Homes for Older People Page 11 of 27 Evidence: It was detailed enough to develop a care plan. The majority of this information was historical as there has only been one new person admitted to the home since the new owners had taken it over. This person said that someone had visited them before they moved in. Peole have been issued with a statement of terms and conditions or a contract before admission to the home. Intermediate care is not provided at Ashurst. Care Homes for Older People Page 12 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care and support they need, although their medication has not always been dispensed properly. The staff provide support in a sensitive way that promotes the independence and dignity of the people who live at Ashurst. Evidence: The case files each contained a care plan based on assessment information of the individual concerned. Evidence was available to show that the plans are usually reviewed each month. A comprehensive review of each plan takes place every three months and this is narrative in style and contains detailed information. Whilst the care plans are reviewed regularly there was no evidience to show these plans are updated, one plan seen was origionally written in 2007 but had not been updated with the changes identifies in the review system. The person they are about or their relative should also sign the care plan and review documents where possible. The case files also contained evidence that peolpe access health services as they need to such as the GP, district nurse, chiropodist, optician and consultant visits where necessary. Care Homes for Older People Page 13 of 27 Evidence: There is a medication policy in place and staff that administer the medication have all had in-house training supplied by the dispensing chemist. There is no evidence to suggest this training is accredited. The home uses the NOMAD medication system and staff were observed dispensing the medication from this system appropriately. However liquid medication, lactulose was being used from one bottle for several people in the home. Whilst all people using the lactulose had been prescribed this medication each person must only receive medication from the container provided by the pharmacist with their details on. An immediate notice requirement was issued requiring staff to cease this practice immediately and to use the medication prescribed for the individual only. This was complied with during the inspection visit and each person who took lactulose had their own bottle of medicine in the drugs cabinet. An audit trail of the medication brought in to the home and returned to the pharmacist is kept and staff signed the returns book. Itis recommended that the person accepting the returns also sign this record. The medciation records were upto date and clearly signed. There is no-one in the home who looks after his or her own medication. Throughout the visit staff were observed treating people with respect and enabling them to retain their dignity. People spoken with said staff are marvellous, I tell everyone including the lady advocate and staff always knock on the door before they come in and they help me with my shopping and the staff let me do what I want and only help me when I ask for help Care Homes for Older People Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in their leisure activities when staff have the time and they are encouraged to maintain positive relationships with their friends and visitors. Evidence: Since the last key inspection people have been consulted about the activities they would like to do. A separate record of activities is kept, these activities include; a motivational therapist, Church services, foot massages, a barbecue on the 16/08/08, and a regular entertainer. The records kept had not been completed since the barbecue and people spoken with said that the social activities had not been as readily available as they had been. The activities have decreased because there has been staffing shortages in the home and staff have been working long 12-hour shifts. Staff confirmed this although they continue to try and provide activities. There were no visitors during the inspection but people spoken with said that their visitors could come at any time and staff always made them welcome. A rolling three-week menu is used in the home. The cook and the assistant manager devise it with input from people in the home, although there was no evidence to Care Homes for Older People Page 15 of 27 Evidence: support this claim. Special diets are catered for and currently they are providing vegetarian and diabetic diets. The meal observed was hot, well presented and where necessary assistance was offered sensitively and appropriately. People said the food is lovely and if you dont like the food they will offer you something different Care Homes for Older People Page 16 of 27 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 are protected from risk of harm or abuse. Policies are in place to inform staff of the actions they should take where they suspect abuse has occurred. Evidence: A complaints procedure is in place and is displayed clearly in the communal areas. Further development should allow for people with different communication abilities and disabilities to access this information. No complaints have been received by the Commission or by the home. People spoken with said that if they had any concerns or complaints they would discuss them with the deputy manager. A safeguarding policy is now in place and is in line with local protocols. Training is planned in this area through staff meetings and in supervision. Staff are aware of their responsibilities in relation to reporting any suspicions of abuse occurring. Staff are thoroughly checked prior to their employment to ensure they are suitable to work with vulnerable people. Care Homes for Older People Page 17 of 27 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 live in a home that is reasonably comfortable. Evidence: A tour of the premises was carried out and the following items were identified as requiring attention: 1- the bathroom next to room 12 is currently used for storage and contained a badly rusted commode and a broken bath seat. These items should be moved out of the home if they are no longer in use. 2-Bedroom 12 had an offensive odour 3- Bedroom 14 did not have a lock on the door and there was black mould on the wall behind the wardrobe 4- Bedroom 16 and 17 did not have a lock on the door 5 - Bathroom next to room 5 the carpet is showing the outline of the floorboards and one of the boards appears to be loose. Care Homes for Older People Page 18 of 27 Evidence: 6 - Bedroom 9 smelt foisty and the window did not appear to open 7- Bedroom 6 the sink area would benefit from updating 8 - None of the shared rooms had privacy screening 9 - The freezers outside looked as if they needed defrosting and cleaning. The communal rooms were warm and people said they were comfortable and clean. The laundry meets the needs of the home. Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who know them and have received training to ensure they have the skills needed to carry out their roles Evidence: There are always two members of care staff on duty over a twenty four hour period. A cook is employed on a daily basis and a domestic is also employed in the home. During the last six months the senior carers has been acting as the manager on a day-to-day basis. Evidence provided in the Annual Quality Assurance Assessment provided in June 2008 showed three staff members have an National Vocation qualification level two in care and a further four members of staff are working towards this qualification. There is a procedure for the recruitment and selection of staff and staff files seen showed this was followed. Four staff files were seen each of them contained an application form and at least one written reference, a Criminal Records Bureau disclosure and/or a POVAFIRST disclosure prior to the commencement of their employment. A local company is providing the training in food safety, first aid, health and safety, moving and handling. Staff are also in the process of completing training on infection control and equalities and diversity. Care Homes for Older People Page 20 of 27 Evidence: Care Homes for Older People Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a management system that lacks cohesion this means that the needs of people living in the home are not always met. Evidence: At the time of this inspection the provider had not appointed a manager to run the home. The home has been without a recognised manager for at least six months. A senior carer has been acting as manager but the Commission has not been told what the management arrangements for the home are. A requirement was made in March 2008 for the provider to inform the Commission about the management arrangements. The registration team sent a letter from the Commission in May 2008 asking for this information and this request was further highlighted as a random inspection, which took place on 1st July 2008. On the 8th October 2008 the Commission was informed that a new manager has been appointed. There is a quality assurance system in place and this consists of surveys going out Care Homes for Older People Page 22 of 27 Evidence: once a year to people in the home, their relatives and to stakeholders. Meetings have been started to facilitate group discussion about life in the home for people who live at Ashurst and for staff. Where possible people look after their own monies. If people need support with their money this is done in a sensitive manner. The cash and records kept by staff is held in the safe and all accounts checked tallied. Staff now receive regular supervision, this has been carried out by the newly designated manager. There is a health and safety procedure in place for staff to read. Staff have training in first aid, fire safety, manual handling, food hygiene and infection control. The storage and use of COSHH materials was found to be satisfactory. The gas and electrical safety certificates were seen and equipment is serviced at the intervals required by the manufacturer. The certificates are now available for inspection at anytime. All incidents and accidents are reported as necessary. Care Homes for Older People Page 23 of 27 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 24 of 27 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 1 29 19 All staff must have two written references prior to the commencement of their employment. This allows the manager to ensure the person applying for the job is of good character and fit to work in a care home 31/12/2008 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 Statement of Purpose and Service user Guide could be further improved by clearly specifying that the service is not discrininatory and does not exclude anyone on the grounds of race, gender, sexual orientation or faith. When a care plan is developed or renewed following a review the person it is about should sign it to show they are aware of this document. People in the home should be consulted on a regular basis about the meals and their views should be recorded. Action should be taken to address the issues identified in the report in respect areas of the environment. 2 7 3 4 15 19 Care Homes for Older People Page 25 of 27 5 30 Staff should be provided with training about the effects of older age and associated illnesses. This will allow them to fully understand the people they are caring for and ensure the support they provide remains appropriate. Care Homes for Older People Page 26 of 27 Helpline: 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 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 © (2008) 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 27 of 27 - 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!