Inspection on 21/10/08 for Ashwood

This inspection was carried out on 21st October 2008.

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

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 15/01/08

Ashwood 19/07/06

Ashwood 23/01/06

Ashwood 02/06/05

Ashwood 28/10/04

Ashwood 02/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashwood 1 Liverpool Road Ashton-in-Makerfield Wigan Greater Manchester WN4 9LH     The quality rating for this care home is:   two star good 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: Judith Stanley     Date: 2 1 1 0 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 25 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 25 Information about the care home Name of care home: Address: Ashwood 1 Liverpool Road Ashton-in-Makerfield Wigan Greater Manchester WN4 9LH 01942722553 01942720577 ashwoodrch@talktalk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Shepherd Type of registration: Number of places registered: Mr Serge Pascau,Mr Dennis Pugh care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 36 service users to include: up to 36 service users in the category of OP (Older People) up to 2 service users in the category of PD (Adults with Physical Disabilities) up to 8 service users in the category of PD(E) (Adults with Physical Disabilities over 65 years) up to 1 service user in the category of DE(E) (Adults with Dementia over 65 years) The 2 PD places are only to be used for service users over the age of 60. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 0 0 2 Over 65 1 36 8 Care Homes for Older People Page 4 of 25 Brief description of the care home Ashwood is a privately owned care home that offers care for 36 older people. It is situated in the centre of Ashton-in- Makerfield close to all local amenities including shops and bus routes. Ashwood offers accommodation to people who require assistance with personal care and support. Ashwood is a purpose built two-storey home that can offer care for 36 residents. Currently all bedrooms have single occupancy. The home is registered for 36 so there is a possibility some of the large rooms could revert back to being used as shared rooms. The manager advised that there are currently no plans to have shared rooms. Only one room offers an en suite facility, however, all rooms have a hand basin and there are toilets and bathrooms on both floors. Level access to the home is provided and a passenger lift ensures access is available to both floors. The premises are well maintained both inside and outside. Car parking is available to the rear of the home. The current scale of fee ranges from 322:65 pounds to 387:00 pounds. Additional charges are made for toiletries, magazines, transport, papers and hairdressing. Care Homes for Older People Page 5 of 25 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: two star good 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: This inspection was unannounced and was carried out over a period of six hours. The inspector looked at some records (care plans) the home holds on residents and other records the home needs to keep to ensure the home is being run properly, for example menus, activities, staff files and staff training. The inspector also looked around the home and spoke with residents and staff during the course of the day. Prior to the inspection the manager was sent an Annual Quality Assurance Assessment form to complete. This tells us what the home does well at and in what areas they can improve and develop. Comment cards were also sent to staff and residents to find out what they think about the home and services and facilities provided. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 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 25 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 9 of 25 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. A detailed pre admission assessment is carried that ensures the home and staff can meet the individuals care and social needs . Evidence: The home has a statement of purpose and a service users guide, these are available for prospective residents and to those residents already living at the home. This information is clear and concise and informs people of the services and facilities available at the home. This information is kept in the foyer of the home along with the last CSCI report. We selected three residents records (care plans) to work with throughout the inspection. On examination of the files all three residents had a written contract in place. Care Homes for Older People Page 10 of 25 Evidence: There was evidence in the care plans to show that a full admission assessment had been carried out prior to residents being admitted in to the home. The assessment form is detailed and includes: residents details, physical condition, continence, sight, hearing and speech, communication, medication, sleep patterns, social relationships etc. The assessment provides staff with the information they need to ensure the individuals care needs can be met and provides the base line for the drawing up of the care plan Care Homes for Older People Page 11 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provided staff with the information they needed to meet the needs of residents. Residents were treated with dignity and respect and their right to privacy was upheld. Evidence: We continued using the same three care plans. Care plans are drawn up from the initial assessment and include personal details such as the name the resident would like to be known as, next of kin and other family details, name of doctor or social worker etc, mental health, personal care, social care, nutrition, mobility and communication etc. Risk assessments covering areas such as moving and handling, bathing, going out of the home and nutrition were in place. Other information includes a personal care record and a record of weight. Daily progress notes are also maintained. The care plans had been updated monthly as required. The services of doctors and the district nurse team and chiropodist were accessed either at the home or in the community. Visits were recorded in the care plans. Care Homes for Older People Page 12 of 25 Evidence: Feedback from residents and those who returned comment cards was complementary about the staff and the care provided. One resident wrote, The staff are very helpful and pleasant, they are always there when you need them. Another resident spoken with said, I am very happy here, I have no complaints, the food is good and the staff are very kind. We looked at the medication and the recording for the three residents whose files we were working with. For two residents the medication and recording was found to be correct. On examination of the third residents medication and recording an error was found. There were more tablets left in the bottle than was recorded on the residents drug sheet. There were two tablets signed for but had not be given. It is imperative that medication is given as prescribed and properly documented. The manager has contacted CSCI and given assurance that a medication audit has been carried out and all medication checked and is correct. The has informed CSCI that senior staff are now coming on shift earlier to audit medication daily. Those residents spoken with indicated that staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. In the main residents were observed to be clean and well groomed. It was evident that good relationships had been formed between residents and staff. A friendly and respectful rapport was heard throughout the day. Care Homes for Older People Page 13 of 25 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. Residents are offered a range of activities to meet thier capabilities and expectations. Residents are provided with well cooked food, which they like, in good portions at times that suit them. Evidence: On the day of the visit, the routines of daily living were observed to be flexible. Residents get up at times that suits them and choose where to spend their day. There are lounges on both floors, however residents tend to use the same one, as is their choice. Activities provided are displayed in both lounges. Some main events are planned throughout the year and include trips out, entertainers, parties and festivals. Other activities are provided for example board games, bingo, arts and crafts, manicures and reminiscence. The lounges are well equipped with a television, video and DVD and music centres. Visitors are welcome to visit the home at most times during the day. The home has a protected meals policy which requests visitors to avoid visiting at meal times to allow Care Homes for Older People Page 14 of 25 Evidence: residents to dine without disturbances. Staff are aware that sometimes it is unavoidable for people to visit during mealtimes but in the main the policy is adhered to. The home encourages residents to maintain links with family and friends from the local community where possible. The home welcomes visits from the local clergy who visit the home and offer communion to residents who wish to partake. Residents religious preferences are documented in the care plans. The menus were displayed in both lounges, these were seen to offer a good choice of nutritional meals. A flexible breakfast is available to allow people to get up when they are ready. A range of hot and cold dishes are offered including cereals, porridge, toast and preserves and a cooked breakfast, tea or coffee. The lunchtime meal was observed and residents were offered fruit juice, steak pie, chipped potatoes and peas, or ham salad followed by dessert. The cook serves the meals from the hot trolley and it was evident that she knew the residents well. She knew who had a good appetite and who would only want a small portion. The cook should be complemented on the way she spoke with one resident who is visual impaired. The cook explained what and where the food was on his plate and assisted him with his cutlery. The meat was cut in to bite sized pieces and was tender. The meal was colourful and nicely presented. The dining tables were nicely set with appropriate cutlery, crockery and condiments. Staff were available to assist any resident who needed help with their meal. Residents spoken with after lunch expressed their satisfaction of the quality and quantity of the food served. A lighter afternoon tea is served, again choices are available. Hot and cold drinks and snacks were served throughout the day and suppers are available before residents retire. Care Homes for Older People Page 15 of 25 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. Residents can have confidence that they will be protected from abuse in any of its forms by effective staff training and procedures. Evidence: A complaints procedure is in place, which gives details of how any complaint or concern will be investigated and dealt with. A copy of the complaints procedure is available in each residents care plan. Information provided prior to the inspection indicated there have been no complaints made to the home since the last inspection and no complaints have been received by the CSCI. One resident spoken with said, I have no complaints, its very good here, if I had though I would speak with the staff. An Adult Protection and Prevention of Abuse policy is in place, which incorporates whistle blowing. The home ensure all staff completes training in the protection of vulnerable adults, which is regularly updated. There have been no adult safeguarding referrals made since the last inspection. Care Homes for Older People Page 16 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintainted to a good standard making Ashwood a homely, pleasant and comfortable place for residents to live in. Evidence: Ashwood is well maintained internally and externally. The home has a lounge with an adjoining dining area on both floors. The erection of the conservatory to the front of the home has been designated as the residents smoking area. The communal areas were well equipped and were comfortable. It was noted that the chairs in the upstairs lounge were heavily stained and in need of cleaning. We were informed that the chairs had recently been cleaned, however the manager has responded to the CSCI since the inspection that this matter will be addressed again. There was also an odour of urine in the lounge, this was detected only in this area of the home and this was discussed with the deputy manager that this must be eradicated. As recommended at the last inspection the corridor carpets on both floors require attention as these are stained and need deep cleaning or replacing. The home was clean and tidy throughout. Several bedrooms were looked at and these were seen to be clean and comfortable and residents had personlised their rooms with their own possessions brought with Care Homes for Older People Page 17 of 25 Evidence: them from home. Bathrooms and showers rooms were domestic in style and are tastefully decorated to offer a relaxed atmosphere for residents when bathing. The outside area of the home was well maitained and the grounds were neat and tidy. Hygiene practices were observed, staff were seen wearing different protecive clothing for different tasks. All bedrooms are fitted with soap dispensers and with paper towels. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels were satisfactory ensuring consistency of care for people living at the home. A staff development and training programme is in place to ensure that staff are equipped with the skills and knowledge required for their roles. Evidence: On the day of the visit staffing levels were sufficient to meet the needs of the residents. A written rota is maintained and corresponded with the staff on duty. Domestic and catering staff are employed and support care staff as required. Several of the staff had worked at the home for a number of years and it was evident that good friendly and respectful relationships have been formed between staff and residents. Staff morale was good and the staff team appeared to work well together. The atmosphere within the home was relaxed and friendly. During the visit staff were observed to respond speedily to requests for assistance made by residents. The home meets the standard of having more than 50 of staff qualified to NVQ level 2 in care. A sample of training records were looked at and covers mandatory training, moving and handling, food hygiene, first aid, fire awareness and protection of vulnerable adults. We asked the deputy manager to check the certificates for one member of staff to clarify the dates of training and which training agency the training Care Homes for Older People Page 19 of 25 Evidence: was carried out with. The files of three staff members were looked at and showed all the necessary checks had been undertaken prior to starting work at the home. All files contained a written application form, two written references, Criminal Records Bureau (CRB) check and other forms of identification. New staff completes a full induction programme on commencing work. Care Homes for Older People Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ashwood is a well managed and well run home. The residents needs are met with a competent and efficient staff team which has the leadership and support of the manager. Evidence: The manager has worked at the home for a number of years and she has extensive experience in managing the home. She has continued her professional development and undertaken a range of training courses. The manager is receipt of the NVQ level 4 registered managers awards and is an NVQ assessor. The way in which the home is run is open and transparent. The manager operates an open door policy so that she may be approached at any time by staff, residents or relatives. Internal and external quality assurance systems are in place. Regular residents and Care Homes for Older People Page 21 of 25 Evidence: staff meetings take place and are minuted. The owner of the home visits on a regular basis and speaks with residents and staff and checks the overall environment. A written report is completed on his findings and these were available for inspection. The home has the Investors in People Award and is visited annually by an external company (RDB) who assess the home and awards a star rating based on their findings. This company has no connection to the CSCI. The home, at the request of residents or their family holds small amounts of money for safekeeping. The money of the three residents whose files we were working with were checked. For one resident there was no money held at the home. Another residents money was one pound over than what was on the balance sheet and the last one checked appeared to be five pounds missing. On further checking it was apparent that the resident had visited the hairdresser and the money had not been deducted from the balance sheet. Since the inspection the manager has carried out a full audit and has confirmed that all monies are correct. Health and safety policies and procedures were in place. Equipment and systems used in the home are serviced and maintained and records are well kept and easily accessible. Certificates of maintenance checks were looked at at the last inspection in January 2008 and were up to date and valid. This will be checked at the next inspection. The manager keeps the CSCI well informed of any events that affect the well being of staff and residents. All accidents, injuries and any incidents that occur are documented and the necessary people are kept informed. Care Homes for Older People Page 22 of 25 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 23 of 25 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 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 Care Homes for Older People Page 24 of 25 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 25 of 25 - 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!