CARE HOMES FOR OLDER PEOPLE
Ashville House Fairfield Road Downham Market Norfolk PE38 9ET Lead Inspector
Mrs Jacky Vugler Unannounced Inspection 13th February 2006 09:50 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 Ashville House DS0000027393.V283077.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. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ashville House Address Fairfield Road Downham Market Norfolk PE38 9ET 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) 01366 383428 01366 383428 FJJ Healthcare Ltd Ms Elizabeth Fielding Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Forty-two (42) Older People, not falling into any other category may be accommodated, the total number not to exceed 42. 1st September 2005 Date of last inspection Brief Description of the Service: Ashville House is a care home providing personal care and accommodation for 42 older people. It has one bed dedicated to intermediate care.It is owned by F.J.J. Healthcare Limited, a company owned and managed by Darrell Jackson, Kate Jackson and Elizabeth Fielding. The home is located in the market town of Downham Market and is close to the shops, pubs and other amenities.The home is a large detached house set in its own grounds. A purpose built extension has been added to this home and this is of a very high standard. Thirty-four of the bedrooms are single and twenty of these have an en-suite facility. One of the four double rooms has an en-suite facility.As a result of this extension, the facilities at the home have been significantly improved, for example, there is now a hairdressing room, two additional lounges, a purpose built laundry room and food stores, a staff room and a car parking area.A passenger lift provides access to the first floor. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection taking place over five and half hours on a weekday. Preparation had taken place in the CSCI office beforehand. Mrs Kate Jackson and Ms Elizabeth Fielding, proprietors, were present throughout the inspection. There were thirty-seven residents accommodated on the day. A tour of the premises was undertaken and some records were viewed. Ten residents, seven visitors, four members of staff, the District Nurse and the hairdresser were spoken with privately. What the service does well: What has improved since the last inspection?
The parquet flooring in the dining room has been sanded and re-finished. There is an ongoing programme of refurbishment and redecoration. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 6 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. Ashville House DS0000027393.V283077.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 Ashville House DS0000027393.V283077.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): 6 Residents assessed and referred solely for intermediate care are helped to maximise their independence and return home. EVIDENCE: The home has one bed dedicated to residents needing intermediate care. In addition, the PCT have recently contracted another bed on a three-month trial basis for those with more complex needs. The residents for the intermediate bed are assessed prior to admission and the majority for the PCT bed, unless there is an emergency, when all the necessary information is obtained. Ms Fielding said that the home has good liaison with the social workers and the rehabilitation team. The physiotherapist and occupational therapist immediately visit the home, as the referral is made on discharge from the hospital. The falls co-ordinator is involved when necessary. The team work to improve the residents mobility and confidence and when the time is right an assessment is made at the resident’s home ready for their discharge. In the majority of cases, they are able to go home. Ashville House DS0000027393.V283077.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): 8 The residents’ health care needs are fully met. EVIDENCE: Care plans are drawn up following a comprehensive pre-admission assessment. Visits made by other health care professionals are recorded in the care plans. These include the GP, District Nurse, community psychiatric nurse, paramedic, occupational therapist, physiotherapist, dietician, continence advisor. Evidence was seen of eye tests, immunisation, audiologist, x rays, diabetic clinic and more. Nutrition and weight are recorded in the care plans. Risk assessments for falls were recorded in the care plans. Exercise was taken on a regular basis with the help of an outside agency. The District Nurses complete a tissue viability assessment and then provide any pressure relieving equipment that may be needed. A District Nurse was spoken with and she said that they had a good liaison with the home and that any advice was always accepted and acted upon. She said that the notes were always accessible and stored appropriately. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 10 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): These standards were not assessed on this occasion. EVIDENCE: Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 11 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): These standards were not assessed on this occasion. EVIDENCE: Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 12 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 The residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: Ashville House comprises of the older original building and a new extension, and these are situated in an attractive, well-maintained garden with a large well-stocked pond. The extension has an attractive patio area, which has many plants, flowers, hanging baskets and garden furniture, making it very pleasant for the residents to look out onto, and use in the warmer months. Both gardens are accessible to the residents and several of the new bedrooms have patios doors leading into the patio area. The standard of refurbishment, furnishings, fixtures and fittings in both units are very high. There is a staff room with lockers and an arts and crafts/hairdressing room. There is a very large lounge overlooking the patio, which is divided into smaller sitting areas by the arrangement of the chairs into small groups. In addition, there is a lounge with a television, a small reception sitting room and a small
Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 13 area in one of the hallways, which residents were seen to use for sitting in. The parquet flooring in the dining room has been sanded and re-finished. A maintenance man is employed for four days a week. There is ample dedicated storage space for wheelchairs and other equipment. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 14 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): 28 The residents are in safe hands at all times. EVIDENCE: The home has a training development record and this shows that fourteen care staff have completed the NVQ level 2 and seven are enrolled on it. In addition the home employs a registered nurse, two student nurses, an occupational therapist and one staff member doing the BTec in care. A further two staff have completed the NVQ level 3 and another is enrolled to do this. These figures evidence that 65.63 of staff at this home have achieved the NVQ level 2 or equivalent with a potential for 90 if the other candidates are successful and retained. The home is commended for this achievement. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 15 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, 35 The residents’ benefit from a home that is well run and managed. The residents’ financial interests are safeguarded. EVIDENCE: The Proprietor, Darrell Jackson is a graduate in social sciences and economics and has spent several years working in project management for charities including Save the Children. He has been actively involved in residential care management for the past seventeen years and is very much involved in the day-today running of the home. The two other Proprietors are Registered Nurses, NVQ assessors and have undertaken a lot of training as well as attending elderly peoples strategy and implementation group meetings, members of social services and health and mental health services for the elderly. The Manager, Jayne Masterson, has completed the Registered Managers Award and is currently working towards the NVQ level 4 in care. She is an NVQ
Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 16 assessor and a trainer for manual handling and first aid. She has completed many other relevant training courses. The home has a policy not to handle any residents’ money. Residents are encouraged to control their own finances for as long as they are able and then the family or an advocate become involved. The families or advocates are invoiced for any money owing, for example, hairdressing, chiropody or newspapers. Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 17 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 x x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 4 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 4 x x x x x x x STAFFING Standard No Score 27 x 28 4 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x x Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Ashville House DS0000027393.V283077.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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