Inspection on 12/05/05 for Ashwood

This inspection was carried out on 12th May 2005.

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

Ashwood 03/04/07

Ashwood 09/01/07

Ashwood 05/06/06

Ashwood 05/12/05

Ashwood 19/08/04

Ashwood 06/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ashwood New Road Ware Hertfordshire SG12 7BY Lead Inspector Neil Fernando Unannounced 12 May 2005 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 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. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashwood Address New Road, Ware, Hertfordshire SG12 7BY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01920 468966 01920 485188 Runwood Homes plc Christine Chambers CRH PC 64 Category(ies) of DE(E) - Dementia over 65 - 64 places registration, with number OP - Old Age - 64 places of places PD(E) - Physical Disability over 65 - 64 places Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for 64 people with old age, or who have dementia (excluding mental disorder or learning disability) and are over 65 years, or who have a physical disability. The Registered Manager must successfully complete the Registered Managers Award, followed by NVQ Level 4 in Care by 31 01 07. Date of last inspection 19 August 2004 Brief Description of the Service: Ashwood is a purpose built home arranged in six internally connected bungalows for 64 elderly people. Each bungalow is self-contained and offers a lounge, kitchen/diner and with adequate bathroom and toilet facilities. All bedrooms are well furnished. The main entrance to the home opens onto a sitting area and conservatory. There are pleasant gardens at the rear and inner courtyards, with mature trees. Admission is via Hertfordshire Adult Care Services. There is a laundry facility and staff members are employed to provide this service. There is a payphone for the use of the service users. A variety of social and recreational activities are offered to residents to choose from and participate. Ashwood is close to the town of Ware, which offers all high street facilities. There is a main transport system, bus and train, within walking distance of the home. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection for the year 2005/6 against the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection (Unannounced) was carried out on 19.08.04. Ashwood is one of several Care Homes owned and managed by Runwood Homes Plc. It is a purpose built home, which is arranged in six internally connected bungalows. The establishment is registered for 64 old people who have dementia (excluding mental disorder or learning disability) and are over 65 years, or who have a physical disability. On the day of the inspection, there were 59 service users accommodated. The inspection took place over half a day in May 2005. Most of the National Minimum Standards assessed on this occasion have been achieved. Ten service users and eight staff members were spoken to during the visit, in order to seek their views regarding the quality of service offered at this home. In the main, evidence available suggests that the care for service users has been maintained to a good standard. What the service does well: The arrangements to enable potential residents, their relatives and significant others the opportunity to visit and assess for themselves the facilities offered at Ashwood appear to be managed sensitively and efficiently. The assessment of needs carried out prior to any service user being offered a place remains comprehensive. Information gathered from discussions with residents, staff members, examination of records and observation of care practice suggests that there is a good degree of consistency and continuity in the quality of service delivery for the service user group. The care planning and review process ensures that the needs/requirements of the service user are identified and addressed in a holistic manner, and unmet needs closely monitored. Service users are being proactively empowered to raise any concern/complaint they may have, if they are dissatisfied with any aspect of the service offered to them. The protection systems including staff recruitment are adequately robust to ensure the safety of service users. In the main, the standard of physical environment is safe and comfortable. Staff members receive mandatory training and they appear to respond well to health and safety matters. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 5. The home’s assessment and admission process is adequately robust thus ensuring that the residents’ needs could be met on admission to the home. Service users and significant other people are being encouraged and they are involved in the decision-making process regarding matters, which affect the residents’ daily lives. EVIDENCE: Good evidence is available to indicate that the prospective service users receive information to assist them decide if the home is suitable for them. Evidence includes the home statement of purpose, a service user’s guide and information gathered from service users and staff members. Details of how to contact the local office of the Commission, Local Social Services and the Health Care Authorities are also available to service users and their representatives All service users are funded by Hertfordshire County Council Adult Care Services and have the (Social Services) Adult Care Services contract on file. The Statement of Terms and Conditions have been updated to include the details stated in standard 2 of the National Minimum Standards. Admissions are planned in partnership with Adult Care Services, service users, Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 9 their relatives and the staff team. Prospective service users are invited to the home for an assessment to be carried out by the staff, in order to ensure that the identified needs can be met and that they also meet the admission criteria. In an emergency, admission takes place on a verbal reference made by the Adult Care Services where all relevant documents in relation to the needs of the user is faxed to the home, prior to the prospective resident moving in. The Manager is aware that when an emergency admission is made, the service user should be informed of relevant information within 48 hours and to meet all other admission criteria set out in Standards 2 to 4. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. Service users’ needs and requirements, including health and personal care are being identified and addressed in a holistic manner. The care planning and review process is effective and service users’ participation is beneficial to them. Service users are content in the manner their needs are being addressed. EVIDENCE: The Care Team Manager reported that all service users have a current care plan. Five staff members interviewed confirmed that care plans are drawn up by the key worker, a member of the home management team and Social Worker, in consultation with the resident, family and other professionals, as appropriate. A random sample of care plans for 6 service users were examined and these were noted to be satisfactory. Care plans viewed indicate that the needs of residents are being identified and addressed in a holistic manner. There is evidence to demonstrate that care plans are being internally reviewed on a monthly basis. It is also noted that there has been some improvement in the level of review notes being maintained, in order to adequately reflect the changing needs and requirements of each resident. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 11 The service users observed during the course of this inspection appeared to be well cared for. They appeared to be comfortable and received care and attention in a timely and sensitive manner. Many service users are able to communicate and they stated that they are satisfied with the care and services they receive. Service users are registered with a GP from five different surgeries. They receive visits from the District Nurses as and when needed. Service users also have access to services of the Podiatrist, Dentist, Optician, CPN, Speech and Occupational Therapist. Information gathered from staff members and service users, records examined and observation made during this visit evidence that the arrangements for health and personal care, all takes place within the confines of the service user’s own room, thereby ensuring privacy and dignity. The home operates a “knock and wait” policy on entering service users’ bedrooms and sanitary areas. Residents spoken to confirmed that staff members treat them with dignity and respect at all times. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15. Service users’ interests, expectations and aspirations are being sought by staff and fulfilled as appropriate. The level of activities should however be improved, in order to provide an adequate level of stimulation for service users’ general wellbeing. EVIDENCE: The home aims to create a relaxed atmosphere with a flexible approach to daily routines. Individual interests, expectations and aspirations are sought by staff and fulfilled wherever possible. These are recorded on individual care plans and care staff members offer support as needed. Details of group activities are publicised and staff members also remind individuals before an event is due to take place. There are photograph displays of various trips and events, which take place. Newspapers are delivered to service users. There are services and communions held at regular intervals and service users are appreciative of these facilities. However, many service users spoken to suggest that they would benefit from a higher level and variety of social and recreational activities, in order to maintain an appropriate level of stimulation – a view shared by some staff members. The Manager reported that the Activities Co-ordinator has left and care staff members appear to be doing their best to facilitate various recreational activities. With this in mind, it is recommended that the vacant post for the Activities Co-ordinator be filled. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 13 Evidence shows that as well as being information obtained as part of the admission process, service users’ culinary likes and dislikes are taken into account in the preparation of menu. The catering and care staff members regularly speak to each service user to seek their views about their taste and preference. Hot and cold drinks are served throughout the day and mealtimes are seen as a social occasion. Service users were complimentary of the quality, quantity and variety of food available to them. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The complaints procedures are well - publicised and known to service users as appropriate. The management of complaints remains satisfactory. There are systems in place and these should ensure that residents are safe and protected from any harm. EVIDENCE: Staff members interviewed demonstrated an understanding of the procedures and their responsibilities towards ensuring that any complaint is dealt with speedily and satisfactorily. Information is available to service users, relatives and professionals on how to make a complaint and how the home intends to deal with it. Information gathered from four service users suggest that they would be able to make a complaint if they were dissatisfied with any aspect of their care. A new complaints record has been introduced recently and this indicates that the home has received three complaints since the last inspection in August 2004. Evidence shows that complaints are dealt with speedily and satisfactorily. The home procedures on the protection of vulnerable adults are satisfactory. Discussion regarding the procedures is an integral part of the induction for all new staff members and this is a subject also included in the NVQ assessment. Staff members were clear that any allegation or incident of abuse would be reported to a senior member of staff and followed up immediately. Staff members have received training on the protection of vulnerable adults. There are, however, a further eight staff members who have not received this training and the Manager is aware that this should be addressed. There are a number of systems in place, which should be adequate to protect service users from abuse. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19 26. This home continues to provide good living conditions and is satisfactory for the individual and collective needs of the service users. The organisation of the establishment in units appears to generate a warm and domestic atmosphere and promotes a more individual approach to service users needs. EVIDENCE: The home is purpose built and is suited to its purpose. It consists of six internally connected bungalows. A programme of routine maintenance is in place and ongoing. The home has employed a handy person who carries out minor repair works and tidies the gardens. The front door leads into the main lounge, which is furnished to a high standard. All areas viewed are accessible, satisfactorily decorated, well maintained, and furnished to a good standard bar two areas: a) The decoration in the main lounge looks old and worn out and would benefit from redecoration – a view echoed by service users; b) The wallpaper in one unit has come off and requires attention. A high standard of cleanliness was evident throughout the areas viewed on this occasion. There were no mal - odours. Gloves, aprons and hand washing Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 16 facilities are provided. The arrangements for the disposal of clinical waste remain satisfactory. Service users reported that they are very happy with the laundry service that is provided. The gardens were noted to be well kempt, with plenty of sunlight. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. The staffing arrangements are deemed to be satisfactory to meet the needs of the current resident group. The recruitment and induction process is robust, which means that residents are in safe hands. Whilst staff members have access to mandatory training to update their knowledge, skills and competency, NVQ assessment for care staff needs attention. EVIDENCE: The staffing details provided and information gained from duty rotas for a period of four weeks demonstrate that 9 care staff members are provided in the morning shifts and 8 care staff members are available in the afternoon shifts. A Duty Manager is available during the morning shifts and a senior in the afternoon shifts. There are 3 waking staff members, including a Team Manager each night. The staffing levels are reviewed regularly, in order to ensure that the needs of service users are met. The staffing levels are deemed to be adequate. The home procedures for the recruitment and induction of staff members remain robust. Good evidence is available to demonstrate that the procedures are being implemented effectively. The recruitment files for two new staff members were scrutinised and found to be in order. Service users value the staff team very highly – “an excellent bunch” reported three residents. Information available indicates that staff members have received all mandatory training to assist them to do their work competently. There are only nine members of staff who have completed their NVQ Level 2 assessment (24.3 ) Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 18 to date. Standard 28 of The National Minimum Standards states that a minimum ratio of 50 of the care staff team should achieve NVQ level 2 or equivalent by 2005. This is an area that should be given a higher profile and therefore, a recommendation has been made. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36 and 38. The management of this home remains satisfactory. The health, safety and welfare of service users, and staff are being safeguarded and promoted. Ashwood appears to be a safe home for residents to live in – a view shared by staff members and service users interviewed. Records are maintained as required. EVIDENCE: There is very good evidence to indicate that the Manager has implemented care and staff management systems including health and safety matters to good effect. Service users and staff have testified to her commitment and the management of the establishment appears to have been consistent under her leadership. The Manager’s application to the Commission for the registered Manager’s post was approved on 30.11.04. It is a condition of registration that the Manager successfully completes the Registered Managers Award followed by NVQ Level Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 20 4 in Care by 31.01. 07. The Manager reported that this is being progressed satisfactorily. All staff members interviewed confirmed that in addition to on-going informal supervision, they receive formal one to one supervision. This has however not occurred within the stated bi-monthly frequency for some members. The Manager understands that some improvement is needed in this area. The home has good procedures to ensure the health and safety and welfare of service users and staff. Staff members receive training to ensure as far as it is possible to do so, that health, safety and welfare are secure and that they can offer safe caring services to the service users. Fire drills and weekly test of break glass points have been carried out within the required frequency and a record maintained. Staff members have received fire safety training. Hot water temperature is monitored regularly, in order to ensure a safe limit of 43 degrees Centigrade at the point of outlet. Windows have been fitted with restrictors for the safety of service users and security of the building. Portable electrical appliances are checked, tagged and a record maintained. The catering staff members have done the basic food hygiene training and care staff members, moving and handling and first aid, as appropriate. COSSH records are held and all accidents and incidents are recorded. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x x x x 2 x 3 Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 22 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 OP19 Regulation 23 (2) (d) Requirement The wallpaper in one Unit has come off and this requires redecorating. Timescale for action 15.07.05 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. 2. 3. 4. 5. Refer to Standard OP12 OP18 OP19 OP 28 OP36 Good Practice Recommendations The Activities Co-ordinators post should be filled, in order to facilitate an adequate level of social and recreational activities for service users. Training on the protection of vulnerable adults should be made accessible to those staff members who have not received this essential course. The main lounge should be redecorated. NVQ assessment for care staff should be given a higher profile so that a minimum ratio of 50 of the care staff team achieve NVQ level 2 or equivalent by 2005. Formal supervision of staff should occur once every two months, at minimum. Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Ashwood I52-I02 S19273 Ashwood v225606 120505 Stage 4.doc Version 1.30 Page 24 - 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!