Inspection on 19/07/06 for Ashwood Nursing Home

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Nursing Home 09/01/06

Ashwood Nursing Home 25/08/05

Ashwood Nursing Home 24/02/05

Ashwood Nursing Home 26/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ashwood Nursing Home 43 Spalding Common Spalding Lincs PE11 3JZ Lead Inspector Mr Toby Payne Key Unannounced Inspection 19th July 2006 08:10 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 Nursing Home DS0000002530.V304394.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 Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Nursing Home Address 43 Spalding Common Spalding Lincs PE11 3JZ 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) 01775 723223 01775 713763 amar@broadleigh.co.uk St Christopher’s Limited Mrs Suria Kumari Webb Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration A condition of registration is that the maximum number of service users in the home with nursing needs does not exceed 23 and the maximum number of service users with personal care only does not exceed 8. 9th January 2006 Date of last inspection Brief Description of the Service: Ashwood Nursing Home is a care home registered to provide nursing and personal care for up to 31 elderly people. On the day of the inspection there were 31 people living in the home. The home is situated on the outskirts of the town of Spalding approximately 1½ miles from the centre of the town. The building was converted for its current use in 1997 and accommodation is on the ground and first floors. The first floor is served by a stair lift. Most of the accommodation is provided in single bedrooms with one shared bedroom on the first floor. All bedrooms have en-suite facilities. The 5 bedrooms on the first floor are registered for personal care only as this accommodation is served by a stair lift. There is limited car parking to the front of the home. The home has gardens and lawns to the front and rear of the property. The fees at the inspection on the 19/7/2006 ranged from £353 to £460. Extras were for hairdressing which range from £6 to £25, chiropody £6, toiletries, personal newspapers and magazines Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.10 am. It was undertaken using a review of all the information available to the inspector regarding our service history about Ashwood Nursing home. It took place over 6 hours. The inspector spoke to 7 residents, one visitor, a visiting Student General Practitioner, a Nursing Student on placement in the home, 5 members of staff and the manager. A representative of the owners was also present for part of the inspection. The main method was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. The inspector also received at the inspection completed comment cards from 18 people. . What the service does well: People living in this home are well cared for by a well managed, educated, committed and competent care team. Those residents who were spoken too expressed satisfaction with the care and service provided by the home. All residents are assessed before entering the home and there is a recreational and activity programme provided which provides stimulation. There is a thorough assessment and review of care with wherever possible the involvement of the resident or their relative/family. There is a comprehensive programme of education provided which ensures that staff know how to care and support people living in the home. People living in the home live in clean, safe, well decorated and attractive accommodation. The home has addressed the requirement from the previous inspection. The home was awarded a 3 Tulips (Excellent) Food Hygiene award in March 2006, as a result of an Environmental Health Officer’s inspection from South Holland District Council in recognition of the standard of food. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 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 Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents receive information to enable them to make a choice as to whether or not they wish to come to this home. Each person is admitted after a full needs assessment has been carried out. Ashwood Nursing Home meets the needs of residents coming into the home. EVIDENCE: The home has produced a detailed statement of purpose and service user’s guide, which were both comprehensive and plainly written. Since the last inspection both of these documents have been updated. A copy of the statement of purpose, past inspection reports and brochures are displayed in the entrance hall to the home. The manager assesses all people before they come into the home. Trial visits can also be arranged. Written confirmation is sent to the resident to confirm that the home is able to meet their needs based on this assessment. Comment cards stated, “I made a decision to come into care myself” and “I made the decision to move here as I could not manage at home on my own. I am very satisfied”. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. Ashwood Nursing Home DS0000002530.V304394.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Resident’s health and personal care needs were met. The care plans were detailed and identified the individual needs of the people living in the home. Medication was safely administered. Residents were treated in a dignified and respectful manner. EVIDENCE: All residents had comprehensive and up to date care plans. These described their health and welfare needs. Records included assessment details, medication, nutrition, weight, communication, mobility, social interests, care plan (including their sleep pattern). There was also a life history, which allowed staff to be aware of the resident’s interests and background. Where required these also included moving and handling, risk assessments and hazard recognition. Care plans showed evidence of promoting resident’s independence, respect and dignity. There was also evidence to show that residents/relatives had been involved in their care planning and reviews. Their signatures showed this. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 11 All staff receive training on privacy and dignity during their induction programme. The home has a policy on this subject. Reference is also made to privacy and dignity in the statement of purpose and service user’s guide. Where required, people living in the home are referred to GPs, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist and Chiropodist. A visiting GP student expressed satisfaction with the professional approach of the staff and commented that the staff knew the background of the residents and how they should be approached. Staff also introduced him and explained the purpose of his visit. The home has Link Nurses who specialise in continence promotion and tissue viability. They meet up with other nurses and promote up to date practice in consultation with the NHS Primary Care Trust. There were also clear directions concerning the administration of medication. Staff responsible for the administration of medication had received training. A nursing student was administering medication supervised by the deputy manager during the inspection. Residents commented, “If I need any help it is there” and “I am very happy”. There are locks to all toilet, bathroom and bedroom doors. Staff showed awareness of the need to promote the resident’s privacy and dignity in a sensitive manner. Ashwood Nursing Home DS0000002530.V304394.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents received a varied programme of social activities. Most residents exercised choice about what they wish to do during the day. However a number of people felt they did not have enough choice about when they wished to get up or go to bed. Residents were offered a choice of well-balanced and wholesome meals. EVIDENCE: Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 13 The home has an activities programme and newsletter, which gives details of activities in the home. Details are displayed on notice boards at the entrance to the home and in the lounge. The care staff provide activities. On admission to the home details of the resident’s interests and lifestyle are obtained. Activities include board games, music and gentle exercise, quizzes and Bingo, foot and spa massage, cheese and wine, reminiscence, video afternoons, outside entertainment. Residents are also assisted with shopping and library books are also available. A church service also takes place and birthdays are celebrated. The home also holds regular meetings with the residents. On the day of the inspection an outside singer was performing for the people living in the home. There was also information about a future Bar B Q on the 12/8/2006. Most of the comment cards showed that residents could make decisions about what they did each day. However there were a few comments about choice when residents wanted to get up or go to bed. The comment cards stated, “bed time is too early and I would like to stay up a little longer” and “my mother says she would like to stay in bed longer in the morning”. During the inspection 2 residents also stated “I don’t always choose when I wish to go to bed, I would like to do this” and “I can’t always go to bed when I wish to do so”. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 14 On admission to the home details of the residents likes and dislikes and dietary needs are obtained. The home has also specific assessments of their nutritional needs. These are included in the care records. As a result of an Environmental Health Officer’s inspection from South Holland District Council, the home was awarded a 3 Tulips (Excellent) Food Hygiene award in March 2006 in recognition of the standard of food. At breakfast there is a choice including a hot meal. This is served between 08.30 and 10.00 hours. At lunch there is a set menu with an alternative where required. This is served between 12.30 and 14.00 hours. An evening meal is provided which offers a choice including a hot meal. This is served between 16.30 and 18.00 hours. Snacks and beverages are available at other times. As it was a very hot day on the day of the inspection there were jugs of cold liquid and staff were encouraging residents to drink. Separate staff provide catering and have food hygiene certificates and a number also had national vocational qualifications. In addition care staff have completed a distance learning programme in food hygiene. Meals can be taken in the dining room and conservatory on the ground floor or in the person’s bedrooms. The menu is displayed in the dining room. All residents made positive comments about the food. Comments were, “the food is ample” and “I like the food”. Staff were seen to sit with residents who could not feed themselves assisting them in a kind and patient manner. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home has a robust complaints procedure in place. Residents and visitors know that any concerns are taken seriously and acted upon EVIDENCE: All staff receive training in communication and how to deal with a complaint. No complaints have been received by the home since the last inspection. Since the last inspection the CSCI has received 2 complaints. One was sent to the home for investigation and a detailed report was then sent to the Commission. This inspection was carried out in response to a complaint brought to CSCI attention. There were no regulation issues identified. The management of the home were fully co-operative during this inspection. The residents comment cards showed 17 out of 18 knew how to make a complaint. Each resident receives a detailed complaints procedure when they are admitted to the home. The complaints procedure is also clearly displayed with other pieces of information on the wall of the waiting area at the entrance to the home and at the top of the stairs to the first floor. None of the residents had any complaints about the home and felt they could discuss any concerns with the staff and manager. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home is well maintained and clean. Residents are provided with safe and comfortable surroundings in which to live. EVIDENCE: A major programme of repainting has been completed. All bedrooms and corridors have been redecorated. Residents who need nursing do not use the rooms on the first floor as this accommodation is served by a stair lift. There is a laundry with 2 commercial washing machines (with sluice cycles) and one commercial tumble dryer. There are also separate staff employed for laundry services. Residents were very complimentary about the laundry service. Comments were, “my clothes are washed and returned ironed” Residents also spoke of how satisfied they were about the cleanliness of the home. Staff were seen to wash their hands thoroughly between residents and gloves and aprons were also available. Ashwood Nursing Home DS0000002530.V304394.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Staff are well trained and competent to deliver the care and support to the residents. Staff are correctly recruited. The number of staff was sufficient to meet the needs of the residents. All staff receive training to enable them to meet the needs of people living in the home. EVIDENCE: A new member of staff who had recently been recruited confirmed that they had been correctly recruited. Residents felt there were sufficient levels of staff to meet their needs. Staff were seen to attend to residents needs promptly. There is a comprehensive training programme for all staff. The home has achieved close to 100 of their care, catering and nurses having received qualifications in care and catering. The home is also a centre for nurses from other countries outside the European Union undertaking an adaptation programme to enable them to be registered by the Nursing and Midwifery Council. The home also provides training for nursing students. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 18 A nursing student on her placement commented, “I have received good mentorship from the manager and found her supportive and I have learnt a lot by being here”. The home staff have POVA and confirmed has a written recruitment and equal opportunities procedure. All been recruited in accordance with these regulations. This includes a Criminal Records Bureau (CRB) check. A new member of staff this. Since the last inspection training has covered fire safety, moving and handling, palliative care and bereavement, managing challenging behaviours, motor neurone disease and abuse prevention. New care staff do not routinely receive codes of practice relating to their caring role. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 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 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, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. There is a competent, well trained, experienced and committed manager. This has lead to a confident, supported and trained staff team. Accurate records are kept of resident’s monies. EVIDENCE: The registered manager who is a registered nurse has extensive nursing, teaching and management experience and has completed a recognised management qualification. She is also an assessor in teaching and clinical nursing practice. She has also been the manager since the registration of the home. Comments from residents on the day were, “ the manager and her staff knows what is going on”, “fantastic” and “I have no complaints”. The comment cards stated, “I am delighted with the care. The staff are very helpful. I feel I can Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 20 phone at any time. The matron was particularly helpful in the early days”, and “I am delighted with the care here” Staff felt safe working in the home and felt able to approach the manager if they had any concerns. There were also regular staff meetings. In order to obtain the views of people in the home, satisfaction questionnaires are sent out to a sample of 5 residents every 6 months. Questionnaires are also sent every 4 months to visitors. The last survey was sent out in June 2006. All of the responses were positive. A representative of the registered provider visits the home weekly. A person acting on behalf of the registered provider carries an unannounced visit out monthly. A report is then sent to the Commission for Social Care Inspection. Where requested the home can arrange to keep money on behalf of the residents. Where this occurs records of all transactions are kept and receipts given. These records were examined and showed evidence of being well maintained and audited every 2 weeks. The home has comprehensive policies and procedures for employment, induction, training and supervision. The home has detailed policies and procedures, which include clinical procedures. Care staff and nurses receive formal supervision 6 times a year. Records examined on the day of the inspection were found to be well maintained and up to date. The home also has an access to records policy and records were kept securely. Records examined and discussion with staff showed that all staff have received fire, moving and handling, first aid and health and safety training. Catering staff have received food and hygiene training. The home also has a detailed health and safety policy and where required, risk assessments have been undertaken. Window restrictors are installed to all windows on the first floor. An outside consultant on the 3/10/2005 reviewed the fire risk assessment. There were no concerns. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 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 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 22 no 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP14 OP29 Good Practice Recommendations It is recommended that the manager reviews the issue of choice in relation to enabling residents to exercise their choice when to get up and go to bed. It is recommended that the manager ensures that each member of the care staff is given a copy of the General Social Care Council’s Codes of Practice and an explanation is given to them of its purpose and their responsibilities. Ashwood Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Nursing Home DS0000002530.V304394.R01.S.doc Version 5.2 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. 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