Inspection on 14/03/07 for Ashwood Rest Home

This inspection was carried out on 14th March 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 Rest Home 15/10/08

Ashwood Rest Home 05/01/06

Ashwood Rest Home 29/06/05

Ashwood Rest Home 19/10/04

Ashwood Rest Home 29/04/04

Ashwood Rest Home 03/11/03

Ashwood Rest Home 21/10/02

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

CARE HOMES FOR OLDER PEOPLE Ashwood Rest Home 10/12 Shirley Avenue Shirley Southampton Hampshire SO15 5NG Lead Inspector Chris Woolf Key Unannounced Inspection 14th March 2007 09:10 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 Rest Home DS0000012397.V332436.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 Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Rest Home Address 10/12 Shirley Avenue Shirley Southampton Hampshire SO15 5NG 02380 780232 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) Mrs Gill Miller Mrs Gill Miller Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20), Old age, not falling within any other category (20), Physical disability over 65 years of age (4) Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 4 service users in the categories PD(E) May be accommodated at any one time. 5th January 2006 Date of last inspection Brief Description of the Service: Ashwood is a care home providing personal care and accommodation for twenty older people over the age of 65 years. The home is owned and managed by Mrs Gill Miller, and provides a service to people with frailty of old age, mental health disorders, dementia and physical disability. The location of the home, in a residential area close to Shirley (a suburb of Southampton), means it is close to the local shops and amenities. The house is a large two storey residential property that has been extended at the back to provide further accommodation. There is a car parking available at the rear of the premises. The home has eight single and six double rooms and en-suite facilities are available in two of the double rooms only. There is a passenger lift for access to the upper floor. The homes surrounding gardens are well maintained and are accessible to all of the service users. The current fees for the service at the time of the visit range from £327.04 to £420.00 per week. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is gill@ashwoodcare.co.uk Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information for this report has been gained from a pre-inspection questionnaire completed by the home, and from a visit to the home. The visit consisted of speaking with the majority of residents, 4 visitors, the manager, and various members of staff; observing practices in the home including the interaction between staff and residents, a tour of the home, and inspection of a selection of records. What the service does well: The home has positive management, a happy atmosphere, and a dedicated staffing team, some of whom have been with the company for many years. All residents appear happy and well cared for, and there is no discrimination between the various categories of resident. The home has a varied activities programme, regular outings are undertaken, and residents are taken out shopping on a regular basis. Visitors are made welcome in the home, and commented, “they always make us welcome, we can come in anytime”. Residents receive a varied, nutritious diet. One resident commented, “whoever cooks, it is good”. The home is well maintained with an ongoing maintenance and development programme. Resident comments included, “The staff are wonderful, they would do anything to help”, “I think its wonderful”, and “We are all happy being here”. Visitors comments included, “I am really happy with everything”, “We like the home”, and “Mum is happy”. Ashwood Rest Home DS0000012397.V332436.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. The summary of this inspection report can be made available in other formats on request. Ashwood Rest Home DS0000012397.V332436.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 Rest Home DS0000012397.V332436.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, & 5. Standard 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents users are given sufficient information to enable them to make an informed decision about admission to the home; they can be confident that their needs will be assessed before admission and they can have a trial visit to ensure that this is the right service for them EVIDENCE: The home has updated its service user guide and has now produced a ‘spoken word’ copy, which has been recorded by one of the existing residents. A comprehensive assessment is carried out for each prospective new resident prior to him or her moving into the home. The assessment takes into account their health, social and cultural needs. Where residents are Care Manager a joint assessment is also received from the relevant Care Manager. The assessments contain sufficient detail to enable the home to be sure that they can meet the prospective residents needs. This home does not accept Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 9 residents unless they are mobile at the time of admission. A resident commented “they came to see me at home before I moved in”. Trial visits are offered, and the first month of occupation is also classed as a trial period. A resident commented, “I tried it out for one day and one night and decided to come for good” A visitor commented, “Mum has settled well”. Ashwood Rest Home DS0000012397.V332436.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): 7, 8, 9, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs are comprehensively recorded, and are met by the home supported by a multi-disciplinary health care team; the homes medication policies and procedures protect residents from harm; they are treated with dignity; and their privacy is respected. EVIDENCE: The home has recently introduced a new computerised care planning system. Staff members commented, “we are learning the computer care plans” Each resident’s care plan is holistic, comprehensive, and based on their preadmission assessment and includes details of their health care, social, and cultural or spiritual needs, together with appropriate risk assessments. They also include information about all contacts with health care professionals. The care plans are reviewed regularly. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 11 The personal and health care needs of the service users are met by the home supported by a team of health care professionals. A resident said, “its good care”. Visitors commented, “The care is good”, “Mum is always clean”, “If mum, or anyone else has a problem they sort them out immediately”, “They are very caring”, and “I have never seen mum dirty”. The homes policies and procedures for the storage, receipt, administration and disposal of medication are sound and are sufficient to allow for an audit trail to be undertaken. Residents are treated with dignity and their right to privacy is maintained. Staff were observed to be knocking on doors before entering; Double rooms either have a screen or in some cases the residents have signed to say they don’t want screens in the room; telephone calls can be taken in private. All staff have received in house training about privacy and dignity. Staff commented, “we knock on doors”, “we shut doors when doing personal tasks”, and “residents always wear their own clothes - they are all marked”. Ashwood Rest Home DS0000012397.V332436.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): 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be happy that the lifestyle in the home will meet their needs and expectations; they will be encouraged to maintain contact with their friends and relatives; they will be given choices in all aspects of their daily lives; and they will receive wholesome and nutritious meals. EVIDENCE: The home organises a good variety of activities and entertainment for the residents and a copy of the activities programme is on display in the hall. Regular outings are organised and residents are also taken out into town by staff to enable them to do their own shopping. The home also has a resident dog, one resident said, “she is a lovely dog” Residents commented, “we do lots of activities, including a piano player, and music with xxx”, “xxx comes to entertain us, we do singing and quizzes, she is good”, “we have films”, “we talk a lot”, “we are a friendly lot”, “I like reading & knitting” and “We go shopping trips to Eastleigh or the Swan Centre at Fareham”. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 13 Visitors commented, “They take them out into the garden on nice days”, and “The activities seem very good”. Staff said, “we do bingo, darts, art & craft, music & exercise”, “we go on trips”, “we take them into town and out for lunch”, “they have movies on a Saturday night”, and “we like to sit and talk to the residents”. On the day of the inspection site visit seventeen of the twenty residents went out for lunch and all agreed they had enjoyed the trip out. Comments on their return included, “We had a nice trip out”, “lunch was nice”, “it was good to see the flowers and catkins out”, and “it was a nice ride on the bus”. Residents’ religious needs are supported by the home; a Church of England vicar visits monthly to do a service, and other denominations are welcome to visit as required by individual residents. Residents are encouraged to maintain contact with the relatives and friends both in the home and outside. Residents commented, “I am going out on Sunday for lunch & tea with my family” “Visitors are made welcome”, and “my relatives take me out”. Visitors said, “They always make me a cup of coffee”, “They make you feel very welcome”, “They always make us welcome, we can come in anytime”, and “They let us use one of the lounges for birthdays as we have quite a large family; and they give mum a cake”. A staff member commented, “we offer visitors tea & cake and talk to them”. Choices are offered to residents in all aspects of their daily lives. Residents said, “we get choices of getting up and bed time, & choose what we wear” and “If we don’t like the meal of the day we can have on of the other options just let the chef know by 11 o’clock”, and a staff member said, “we give them choices of what to eat, what to wear, where to sit, what to drink, and where to have breakfast, their own rooms or in the dining room”. The home provides residents with a balanced and nutritious menu. Residents commented, “The food is very good”, “he is a good chef”, “the food is good, we get choices”, “The food is alright”, “we have homemade cakes - In the afternoon we have a cup of tea and a cake or bun”, “the food is up and down, I don’t like suppers much but I can have something else if I want”, and “the cook is good whoever cooks”. Visitors said, “They always feed her, she eats every bit”, “the menu always sounds nice”, and “They always tell us if she has not eaten”. Staff comments included, “they have three veg most days, nearly all fresh”, “the food is nice”, “We have lunch provided if we are working”, and “I do the cooking sometimes, they particularly like my stew and dumplings and my rice pudding”. Ashwood Rest Home DS0000012397.V332436.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): 16, & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that any complaints they make will be investigated and dealt with appropriately; and that they will be safeguarded from abuse. EVIDENCE: The home has a clear complaints policy and a copy is on display. There has only been one complaint since the last inspection, this was forwarded to the home by CSCI, and was properly investigated. The complaints log indicates that complaints and their outcomes are properly recorded. Staff confirmed they would know how to deal with any complaints they may receive. A resident commented, “I am satisfied with it generally”, and a visitor commented, “We have never had to make a complaint”. The home has clear policies regarding the protection of vulnerable adults. Staff are trained in Adult Protection. Staff confirmed their awareness of adult protection strategies and of the whistleblowing policy. All new members of staff are checked against the Protection of Vulnerable Adults register prior to commencing work in the home. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 15 Ashwood Rest Home DS0000012397.V332436.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is clean, comfortable, safe, and well maintained; with bedrooms that are personalised to meet their needs. EVIDENCE: The home is safe and well maintained, since the last inspection there have been a lot of improvements including the redecoration and re-carpeting of halls, stairway and corridors; new carpets in the lounges, new flooring, tables, chairs and crockery in the dining room. Four bedrooms have been decorated and re-carpeted, a new fridge and microwave have been fitted in the kitchen; new fire extinguishers have been purchased, all emergency lights have been renewed and the kitchen fire door has been fitted with an automatic door guard. The garden is pleasant and accessible to residents. One resident commented, “we go out in the garden, we have a nice big garden” Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 17 There are eight single and six double bedrooms in the home. Two of the double bedrooms have en-suite facilities. Screening is available in double rooms to allow personal tasks to be carried out in private, although some residents have opted not to have screens in the room and this is documented. Residents are able to bring some of their own belongings to personalise their rooms. One resident commented, “I’ve got a nice bedroom” The home is clean with no unpleasant odours. Infection control procedures are sound. Visitors commented, “It’s always nice and clean”. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a sufficient number of properly trained staff. Recruitment procedures are sound and ensure protection of the residents EVIDENCE: The staffing levels in the home are sufficient to meet the needs of the residents, and to enable them to enjoy outings and trips to town. Residents commented, “there are enough staff to look after us”, “if we need someone there is always someone available”, “We get help if we need it”, and “The staff are wonderful, they would do anything to help”. Since the last inspection additional NVQ training has been undertaken and the home has now reached the required 50 of care staff with NVQ Level 2 or above. A staff member commented, “I have just finished my NVQ 2”. Recruitment procedures are sound. No new member of staff is employed until 2 satisfactory references have been received, an enhanced disclosure has been submitted to the Criminal Records Bureau, and a satisfactory check of the Protection of Vulnerable Adults register has been received. Staff files need to be updated to comply with the revised Schedule 2 of the Regulations and a recommendation has been made regarding this. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 19 Staff training is ongoing. All staff are up to date or booked on courses for mandatory training. The home has updated its induction to comply with the Skills for Care requirements. 8 staff have undertaken training in adult protection and the remainder are booked to attend a course. Staff have received training in mental health and managing challenging behaviour. Some staff are currently doing COSHH training. The cook commented, “I have an Intermediate food hygiene certificate”. General comments from residents included, “the staff are very good”, and “Generally I get on very well with the staff”. Visitors said, “I like all of the staff”, and “The staff are very good, very caring”. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 20 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. Sound management, and a home that is run in their best interests, support residents; their financial interests are protected by the homes policies and procedures, and the health, safety and welfare of residents and staff are safeguarded. EVIDENCE: The home is owned and managed by a suitably qualified and competent manager, who is supported by a trainer/facilitator. A resident commented, “the manager is very good”. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 21 The manager promotes a friendly, open and positive atmosphere in the home and is very supportive of residents, visitors and staff. Staff members commented, “If Gill left we would go”, “She is very good to the residents”, “She is on call 24 hours a day”, “We can always talk to the manager - cant fault her at all”, “Gill did me a party and presentation for 20 years”, “I had something for my 10 years”, and “She treats us very well”. Visitors said, “the manager is supportive when I see her”, “Gill always pops in and we can always go to her. We can phone at anytime”. The home has developed their quality assurance strategies. Some questionnaires have recently been circulated and others are in the process of being developed. An analysis of the results is planned. Regular audits take place. Policies and procedures are reviewed annually. Residents meetings are held every 4-6 weeks and staff meetings are also held. A staff member said, “we had a staff meeting last week”. The home looks after the pension cards for three of its residents and the procedures and recording for this is appropriate with double signatures for all transactions. Staff have regular supervision sessions. A recent supervision included discussion on discrimination and stereotyping. A staff member commented, “we have regular supervision”. The health and safety of residents and staff is supported. The home has recently has a Health & Safety Risk Assessment and Inspection report. All safety certificates inspected were up to date. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 22 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP29 Good Practice Recommendations Staff files should be updated to comply with the revised Schedule 2 of the Care Homes Regulation 2001. Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Ashwood Rest Home DS0000012397.V332436.R01.S.doc Version 5.2 Page 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. 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