Inspection on 27/04/07 for Ashview Nursing Home

This inspection was carried out on 27th April 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

Ashview Nursing Home 04/05/06

Ashview Nursing Home 13/01/06

Ashview Nursing Home 14/09/05

Ashview Nursing Home 24/09/04

Ashview Nursing Home 19/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ashview Nursing Home Ware Road Widford Nr Ware Hertfordshire SG12 8RQ Lead Inspector Yoke-Lan Jackson Unannounced Inspection 27th April 2007 08:25 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 Ashview Nursing Home DS0000019272.V337312.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. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashview Nursing Home Address Ware Road Widford Nr Ware Hertfordshire SG12 8RQ 01279 842 458 01279 841 108 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) Mr P Patel Mrs Anjani P. Patel Caroline Elizabeth Jones Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 32 older people, who are frail, in need of nursing care. This home may accommodate 32 older people for respite nursing care. Date of last inspection 4th May 2006 Brief Description of the Service: The current proprietors were first registered in respect of Ashview Nursing Home in 1997 under the Registered Homes Act 1984, subsequently under the Care Standards Act 2000 in 2002. The home is registered to care for up to 32 physically frail service users in need of nursing care over the age of 65 years. Qualified nurses and carers provide Twenty-four hour staff cover. The home is a large, old country house situated in a rural area on the outskirts of the village of Widford, between Much Hadham and Ware in East Hertfordshire. The building has been extensively refurbished to provide accommodation on two floors served by a lift. Assisted bathing facilities are provided. Because the home was not purpose-built there are varying floor levels, which have been rendered safe for wheelchair users by means of ramps in corridors. There is a large garden to the rear and limited car parking for staff and visitors to the front of the building. Fees ranged from £513 to £700 (these were correct at the time that this inspection took place). Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector and included a tour of the premises. Time was spent in discussion with service users, staff, visitors to the home and relatives. Standards of record keeping were good. A social function had been arranged and was well supported by the local community. What the service does well: What has improved since the last inspection? What they could do better: Whilst it is probably beyond the control of the service, a small number of service users would benefit from receiving physiotherapy. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 6 Staff were perceived as being helpful and supportive, but there appear to be occasions when some use a language other than English in the presence of residents. This could be construed as being disrespectful. The kitchen floor appeared to be difficult to clean and the ventilation was poor. During the course of this site visit, a visitor suggested that residents could be offered the opportunity to undertake a little light gardening as the home already has a raised flower bed available. The Commission would wish to support this suggestion. 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. Ashview Nursing Home DS0000019272.V337312.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 Ashview Nursing Home DS0000019272.V337312.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): 1, 2, 3, 4 & 5. Quality in this outcome area is good. Prospective service users and their supporters receive sufficient information to enable them to make an informed choice about the home and can visit before coming to any decision about their future. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The policy of this service is that all prospective service users are subject to a pre-admission assessment before a place is offered. Wherever possible, prospective service users and their supporters are also encouraged to make a social visit before they make their decision. A clear service user guide is available on request and each resident (or their family) is given a copy. Documentation contained in care plans included pre-admission assessments, which indicated that only prospective service users whose needs match the registration category of the home will be admitted. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. Health and personal care is delivered in a positive and suitable manner although staff should be aware that it is inappropriate to use a language that is not understood by the residents as this is disrespectful. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans examined were to a good standard with key information easily retrievable. Regular reviews were being undertaken and monthly weight charts were being maintained. No service users were completely dealing with their own medication but staff do endeavour to ‘share’ the administration of medication with residents in a way that medication is not reduced to a process that is ‘done to’ an individual. The process was observed during this inspection. Records were maintained to a good standard. The local Pharmacist provides regular training on the administration and storage of medication. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 10 Good rapport exists between the service users and the staff and most residents spoken to confirm this. However, there appear to be occasions when staff use a language other than English in the presence of residents and this could be construed as being disrespectful. The manager said she would remind staff that this was the service users’ home. Four service users require PEG feeds, and whilst only trained staff oversee this, all care staff have a raised awareness of safe practice and would alert trained staff of any possibility of a complication. The services of a Speech Therapist and a Dietician are available to ensure that health care needs are met and maintained. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. People who use this service can expect to be enabled to maintain contact with their families and to enjoy a degree of contact with the local community if they choose. They may expect a variety of wholesome food and may also expect to be offered choice. A limited, but challenging activities programme should enable those who wish to join in to have at least some of their recreational interests met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Comments from residents about their daily lives included, “We read newspapers, watch TV and chat” and “Everything is hunky-dory”. Several residents have newspapers delivered. All comments received about the food were positive. There are regular deliveries of fresh produce and residents with impaired communication are offered a picture book to help them make their choices. There was a coffee morning arranged to take place during this site visit. It was well supported by people from the local community, one of whom had also brought a dog with them. Ashview appears to have a strong presence in the community and ‘Ashview News’ is a regular feature in the local Parish paper Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 12 and includes residents’ experiences of living at the home. One visitor confirmed that “The home is integrated into the village and they have won awards for this”. Another visitor was planning to make a suggestion that residents who wished could be helped to garden as the home already has a raised flower bed available. The Commission would wish to support this suggestion. Following the departure of the principal activities co-ordinator, the residents still benefit from the considerable talents of a part-time activity co-ordinator who usually calls once a week. She was able to reel off a wide variety of activities that she organises ranging from social events such as those described above to cooking and concerts provided in the garden by local children. She also was arranging to send relatives copies of photographs taken at one of the organised visits by a number of residents to the local village pub. Where residents cannot easily go out, she tries to compensate by bringing activities in; for example, a clothes sale had been arranged. The local vicar can be relied on to conduct communion at the home. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. Quality in this outcome area is good. Service users are protected from abuse and that they have a presence in the home where their input is actively sought. This ensures that no individual should be overlooked. The complaint process appears to be well managed and transparent. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager has dealt with two letters of complaint since the last inspection took place and both appear to have been appropriately resolved. Those residents that were asked said that they knew how to make a complaint and “Wouldn’t be afraid to speak up”. Staff appeared to be knowledgeable about the correct processes to follow if they received a complaint or indeed, if they wished to make one themselves. The proprietor’s representative makes himself available to residents and staff when he calls. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Quality in this outcome area is good. Environmentally, the home can now offer a safe and comfortable facility for service users. There is sufficient specialist equipment to help staff to maximise independence. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The service provider has continued to pay attention to the environment. A tour of the premises confirmed that a good standard of cleanliness was maintained. There has been attention to the appearance of the home and much redecoration has taken place since the last inspection. The Group Handyman attends the home Tuesdays and Fridays as well as responding to any emergencies. Residents said that they were satisfied with their accommodation and many bedrooms contained personal items that reflected the likes of the occupant. There is a bedroom that could be shared, but at present it is laid out for single Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 15 occupation. Most bedrooms have pleasant outlooks and the large garden at the back of the building provides an attractive resource during clement weather. The manager confirmed that there is sufficient equipment available, that eighteen new electric profile beds are to be provided and that some replacement carpets were on order. The new beds will benefit both the residents and the staff. However, the kitchen floor appeared to be difficult to clean and the ventilation was poor. The cook explained that there would be a new external door introduced into the kitchen that should help improve temperature whilst cooking. The work on the basement is almost completed and, although the use of the additional space has not been finalised, it will probably include a new food store, laundry and a staff rest room. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 &30. Quality in this outcome area is good. Staff receive training that equips them to be competent in their work. There are adequate numbers of staff deployed and service users should be assured that they are in safe hands. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home was reported as being appropriately staffed and three full-time care staff have been recruited since the last inspection took place. Although when on duty, the manager continues to be the second nurse, both trained staff on duty felt that staffing levels were suitable to meet the current assessed needs of the residents. There were five vacancies and most residents being accommodated are not independently mobile and rely on the use of a hoist. However, although they have disabilities, most are not nurse dependent. The staff attend one resident who requires percutaneous endoscopic gastronomy feeds (PEG) during the day and three overnight. Some bank nurses cover annual leave and emergencies. Regular staff meetings (minuted) are held and good practice issues can be raised with the provider’s representative when he calls. Trained staff are undertaking study days in their own time and this does not appear to be appropriate. One of the trained staff was asked by the inspector to liaise with the provider’s representative about Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 17 this when he next calls. Five care staff have NVQ3, one has NVQ2 and others are undertaking studies at the moment. There are robust recruitment processes and this was demonstrated by complete staff records for all newly appointed staff. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38. Quality in this outcome area is good. Service users are benefiting from a strong management team and an established workforce that combine to create a home that is generally run in their best interests. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has been well managed during the absence of the registered manager. On return from maternity leave, the registered manager may transfer to another home in which case the acting manager will be offered the post. Staff confirmed that they work well together and that there were clear lines of accountability. Appropriate professional support and supervision is available to all staff. The service has a quality assurance system that incorporates the Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 19 views of service users and other key stakeholders. Other records required by legislation were kept to a good standard on this occasion. Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 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 3 18 3 2 3 3 3 3 3 3 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 3 3 X 3 3 3 3 Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP10 Good Practice Recommendations Staff should be reminded that using a language not understood by service users whilst in their company is disrespectful, even if the conversation is only intended to be between staff members. It is recommended that the floor covering in the kitchen be replaced as the current finish is hard to keep clean. It is recommended that the ventilation in the kitchen be reviewed as the working conditions are poor when cooking is taking place. 2 3 OP19 OP19 Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Ashview Nursing Home DS0000019272.V337312.R01.S.doc Version 5.2 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. 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