Inspection on 09/01/07 for Ashwood

This inspection was carried out on 9th January 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

Ashwood 03/04/07

Ashwood 05/06/06

Ashwood 05/12/05

Ashwood 12/05/05

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 Bijayraj Ramkhelawon Key Unannounced Inspection 9th January 2007 10:00 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 Ashwood DS0000019273.V326455.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. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Address New Road Ware Hertfordshire SG12 7BY 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) 01920 468966 01920 485188 www.runwoodhomecare.com Runwood Homes Plc Christine Chambers Care Home 64 Category(ies) of Dementia - over 65 years of age (64), Old age, registration, with number not falling within any other category (64), of places Physical disability over 65 years of age (64) Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Manager must successfully complete the Registered Managers Award, followed by NVQ Level 4 in Care by 31.01.07. 20th September 2006 Date of last inspection 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. 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 centre of Ware, which offers all high street facilities. There is a main transport system, bus and train, within walking distance of the home. At the time that this inspection took place, fees ranged from £432-£580 Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 9th of January 2007. There were two inspectors and it took one whole day. The inspection focussed on the key Standards set by the National Minimum Standards for Older People and examined further into the requirements and recommendations made in the last inspection. Service user, their relatives, visitors and staff were spoken to in relation to their experiences and their views about the service provision. Care plans, records and other documents as required by legislations were examined. These were kept in good order. Care plans were well documented and showed that service users’ needs were being met and staff said that they were happy to be working at the home and that they were well supported by management team. The management has been proactive in ensuring that all the requirements and recommendations made in the last inspection were met. The home has taken corrective measures to promote and maintain safe practices. What the service does well: Fees £432- £580 Feedback from service users and their relatives was positive. Care plans examined showed that service users needs were being met and that their privacy and dignity was respected. The home had received a number of compliments in relation to the provision of care. Complaints have been dealt with in accordance with the complaints procedure. Service users were complimentary of the staff, food and their rooms. They were encouraged to participate and air their views at meetings. Records were generally kept in good order. The management operates an open door policy and is transparent. There was an enthusiastic, dedicated and caring staff team who took great pride in the service provision. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Bathrooms must not be used as storage. Night care staff should ensure that they maintain a log for each service user. Handwritten changes or additions to medication records should be signed and dated by the person making the entry. Medicine containers should be dated when first opened for ease of reconciliation and auditing. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 7 The dripping tap in the service user’s bedroom should be repaired. The hair-dressing salon should be kept cleaned and tidy. Badly stained areas in kitchenettes in bungalow (1) and (2) should be rectified. Bars of soap should not be used in communal bathrooms and washing liquid should be provided to prevent the spread of infection. 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. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 8 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 Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 3 Each service user has a comprehensive assessment of their needs carried out prior to moving to the home. EVIDENCE: Care plans examined included a detailed assessment of needs for each service user. Reports from other professionals formed part of these care plans. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 7 -10 Good care practices and interactions between staff and service users were observed. Care plans had the required documentation and were reviewed on a regular basis to reflect the changing needs of service users. The administration and management of medicines was satisfactory. However, medicine containers should be dated when first opened for ease of reconciliation and auditing. Handwritten changes or additions to medication records should be signed and dated by the person making the entry. Night care staff should ensure that the night log is kept up to date so that a continuity of care provided is maintained. EVIDENCE: Care plans examined had the relevant information including assessment of needs, health and personal care being provided. It was noted that the night log was not kept up to date in some of the care plans. Care plans were reviewed on a regular basis to reflect the changing needs of service users. A monthly Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 11 audit of falls is undertaken and appropriate advice is sought from the falls prevention team. Service users spoken to confirmed that they were well cared for and their individual needs were being met. The administration and management of medicines was satisfactory but medicine containers were not dated when first opened. Handwritten changes and additions to the medication records were not signed and dated by the person making the entry. Service users who required nursing care had regular input from the District Nurses. All service users were registered with a GP and a log of visits from them, District Nurses, Community Psychiatric Nurses and all other health care agents was maintained. All service users were appropriately dressed, well groomed and they confirmed that staff addressed them by their preferred names. Staff members on duty were observed to deliver care and to attend to service users’ needs in a manner that was conducive to respect for their privacy, dignity, choice and wishes whilst actively promoting independence where possible. All personal and intimate care practices were carried out behind closed doors. Doctors and District Nurses also see service users in the privacy of their own rooms. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12-15 Autonomy and choices for service users were exercised. Day care activities were being planned and provided for service users. A choice in the menu was provided to service users. EVIDENCE: A programme of weekly activities was displayed on the notice board. Service users commented that the variety of activities provided was adequate and they were also able to choose which activity they wished to participate. The lunch was unhurried with assistance and encouragement given by staff. Tables were laid nicely and a choice of drinks was available and there was individual cutlery. Service users spoken to were complementary of the food provided. The current menu now has a choice of hot meals. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 13 Personal belongings were evident in service users bedrooms. Service users have their relatives or social workers or solicitors as advocates. There was a monthly service users meeting held with minutes kept. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16 and 18 The home has a complaints procedure which service users and visitors spoken to were aware of. Staff have attended training in the protection of vulnerable adults. EVIDENCE: A copy of the complaints procedure was available to prospective and current service users. Those spoken to said that they were aware of the complaints procedure but would prefer to speak to a member of staff or the manager if they had any concerns. Staff confirmed that they have received training on Protection of Vulnerable Adults. Nine complaints have been received since the last inspection and eight have been dealt with and one is ongoing. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 19,26 The home and its surroundings offer a pleasant, comfortable and safe environment to its service users. The home was kept clean and generally well maintained and bedrooms were personalised offering a homely, lived in feel. However, bathrooms must not be used as storage so that service users are not put at risk. Some areas of the home require some maintenance. Hand washing liquid should be provided in communal bathrooms to control the spread of infection. EVIDENCE: Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 16 The communal areas were homely with ornaments and pictures. Bedrooms had personal belongings of service users. Accommodation is provided for single occupation on ground floor, which were accessible and safe. The gardens were well maintained. Each bungalow has a lounge and a kitchenette/diner. A separate smoking room has now been identified away from the main lounge. It was noted that bathrooms were being used as storage where mattresses, carpet cleaners and other equipment were stored. One of the service user showed the constant dripping of the hot tap in her bedroom. The hair-dressing salon was dirty and untidy. The kitchenettes in bungalow (1) and (2) had very badly stained areas including the work tops, the flooring, skirting boards and behind the sinks. Soaps were being used in communal bathrooms and no hand washing liquid was provided to prevent the spread of infection. All the above identified shortfalls were shown to the manager on the day of the inspection. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 27-30 The skills and experience of staff were varied. There was an enthusiastic, dedicated and caring staff team who took great pride in the service provision. The number of staff allocated on duty and the training provided for them ensure that service user’s needs can be met at all times. EVIDENCE: There was adequate number of staff rostered on duty per shift during the day and night. There were also adequate number of domestic and catering staff allocated per day and the home has the services of a maintenance person. Service users were complimentary about their rooms, staff and food. They said that ‘ staff are caring, helpful and looked after us’. Food is nice too and plenty. Staff files inspected had all the relevant documents required by this Standard. Staff spoken to confirmed that they have received appropriate training, this included statutory training. They also said that they receive regular supervision and an annual appraisal and they have been given a copy of the General Social Care Council Code of Conduct. Ashwood DS0000019273.V326455.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,33,35, 36 and 38 Service users, their relatives, visitors and staff were encouraged to air their views with regular meetings held and minutes kept. Financial management procedures were in place. There were policies and procedures in place to ensure that service users’ rights were protected. There was an enthusiastic, dedicated and caring staff team who took great pride in the service provision. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 19 EVIDENCE: The management has an open-door policy where staff could see them at any time with any issues or concerns they may have. All statutory records were available for inspection and maintained in accordance with legislation. Staff spoken to were aware that service users can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of service users were promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. The CSCI has been kept informed of all accidents and admissions to hospital. A valid insurance certificate was displayed in the reception area and this offered cover of no less than £5 million. Ashwood DS0000019273.V326455.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 X x 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 X 18 3 2 X X 2 X X x 2 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 X 3 X 3 3 x 3 Ashwood DS0000019273.V326455.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. 1. Standard OP22 Regulation 13 (4) (a) Requirement Bathrooms must not be used as storage. Timescale for action 22/03/07 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. Refer to Standard OP7 OP9 Good Practice Recommendations Night care staff should ensure that the night log is entered so that a continuity of care provided is maintained. a) Handwritten changes or additions to medication records should be signed and dated by the person making the entry. b) Medicine containers should be dated when first opened for ease of reconciliation and auditing. Dripping tap in the service user’s bedroom should be repaired. a) The hair-dressing salon should be kept cleaned and tidy. b) Kitchenettes in bungalow (1) and (2) should be kept cleaned. Soap should not be used in communal bathrooms. c) Hand washing liquid should be provided to prevent DS0000019273.V326455.R01.S.doc Version 5.2 Page 22 3. 4. OP19 OP26 Ashwood the spread of infection. Ashwood DS0000019273.V326455.R01.S.doc Version 5.2 Page 23 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. 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