Inspection on 29/06/05 for Ashwood Rest Home

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashwood Rest Home 15/10/08

Ashwood Rest Home 14/03/07

Ashwood Rest Home 05/01/06

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 Lead Inspector Liz Normanton Unannounced 29th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashwood Address 10/12 Shirley Avenue, Shirley, Southampton, Hampshire, SO15 5NG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 02380 780232 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 (20), Old age, not falling within any other category (20), Physical disability over 65 years of age (4) Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No more than 4 service users in the category PD(E) may be accommodated at any one time. Date of last inspection 19th October 2004 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 a family run business and provides a service to people with frailty of old age, mental health disorders, dementia and physical disability. The home is situated in a residential area close to the city centre of Southampton and as such 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 facility at the back of the premises and also on-road parking outside the home. The home has eight single rooms and six double rooms. No en-suites are available. There is a passenger lift. The homes surrounding gardens are well maintained and are accessible to all of the service users. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the first in the inspection year. The inspection took place mid week. On arrival the inspector spent time with the manager discussing plans for the future of the home. The manager accompanied the inspector on a tour of the building, the inspector was able to observe that service users were able to get up in the morning at their leisure, some were still in bed, others were in the dining room and some in the communal lounges. The inspector then spent time with the training facilitator, and looking at policies and procedures within the home. The inspector sat with service users at lunchtime, she noted that people were eating different meals and the meals provided were good in portion size. The roast dinner was very good but unfortunately the cabbage was over cooked. A number of service users complained about the quality of the food provided at the home. Following lunch the inspector undertook a further inspection of the premises and found that the communal lounge areas had a good variety of seating but this had become old and worn with some furniture damaged. Carpeting in these rooms was also showing signs of ageing. A number of bedrooms were seen to be well decorated and carpeted whilst a number were in need of some attention. Paintwork throughout the halls, landings and stairwells was found to be grubby and chipped in many areas, however the home has been refurbished in other areas over the past eighteen months. During the course of the inspection the inspector talked with service users and relatives who spoke highly of the service provided. What the service does well: What has improved since the last inspection? The cabinet of staff lockers has been removed from the dining area as required from the last inspection. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 6 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 Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 The home provides prospective service users and their families information and advice about the home, which would enable them to make an informed decision. EVIDENCE: The inspector viewed the home’s Statement of Purpose and Service Users Guide and found them to have all the necessary information as required to enable prospective residents the opportunity to make an informed decision. Visiting relatives confirmed that they had seen both documents. The service users guide is produced in large print for those with visual impairment. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The home provides each service user with individual care plans, which identify their health and personal and social care needs. Service users’ health care needs are met, and medication is administered in a safe way. Service users are treated with dignity and respect. EVIDENCE: The inspector viewed three service users’ care plans and found them to have all the necessary details to enable staff to meet individual care needs. The care plans also included risk assessments and had up to date photographs of service users on file. The inspector saw signed evidence that service users are involved with the drawing up and review of their care plans. Service users’ health care needs are met. Health care needs are recorded on the care plans. The home has links with health professionals. A mental health doctor visits service users who have mental health problems. Service users are also supported by the mental health service and may occasionally be referred to the hospital as required. The home consults with a continence advisor who undertakes assessments. Pads are supplied to the home monthly. The inspector saw evidence of dental and optician appointments on the staff notice board. One service user had been accompanied to the dentist in the morning Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 10 but did not receive treatment. The home does not have an exercise programme but service users exercise when they access the communal areas of the home. The inspector observed a number of service users using the garden. The care plans evidenced that service users are registered with doctors, the training facilitator informed the inspector that most of the GP surgeries are in the local area. A chiropodist visits the home every six weeks. The home has policies and procedures with regard to the administration of medication. The home has recently introduced the Monitored Drugs System from Boots chemist. All medication is stored appropriateley. Medication is administered by trained staff. One gives out the medication and one signs to say they have seen it being administered to the service user. The inspector examined the MARS charts and counted a number of medicines against these and found them all to be present and correct. The safe keeping and recording of controlled drugs is in keeping with the Misuse of drugs (Safe custody) Regulations 1973. Staff are alerted to any change in medication for service users and monitor health accordingly. The home seeks advise from the advising pharmacist and dispensing service advisor. The service users were observed by the inspector to be treated with dignity and respect by the staff. Service users and visitors confirmed that staff treat them with dignity and respect. The most recent person to be admitted prefers to be called by a nickname and family visitors said staff were doing this. The manager was observed to knock on people’s doors before entering. Personal care is provided in the privacy of the bathroom or service users’ bedrooms. Service users have the choice to meet with visiting doctors in the privacy of their room or the office. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 The home provides service users with a variety of social contacts and activities. Family and friends are welcome to visit at any time. Service users are able to exercise choice and have control over their lives. EVIDENCE: The inspector noted that the home displayed activities on a notice board. Service users’ social activities, likes and dislikes were written into care plans. One family member confirmed that the home provides activities. Service users consulted by the inspector said that the following activities were available, quizzies, sing-a-longs and an entertainer who comes twice a week. The inspector was informed that three service users go out to the hairdressers, a nail technician visits the home monthly. A religious service is held monthly and a priest does communion once a fortnight. Service users are enabled to go out in the community shopping and visit cafes and restaurants. The inspector observed that relationships with family and friends is promoted, with a number of visitors being present in the home throughout the inspection. Five service users handle their own financial affairs. Family members handle the remaining service users’ financial affairs. The service user guide states that service users can bring their own furniture. Some bedrooms inspected had furniture belonging to the service users. Service users have access to their records if they so wish. One service user has chosen to have her washing laundered separately from others and this request has been facilitated. Service Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 12 users are able to choose what meals they will have and how they would like to spend their time. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has policies and proedures to enable service users to make complaints. These are taken seriously and acted upon. The manager has ensured that service users are protected from abuse. EVIDENCE: The inspector noted that the home does have policies and procedures in place for the handling of complaints. No complaints had been made for over two years. One visitor stated they had had made a complaint two years ago and that this had been heard and acted upon. A number of service users told the inspector that they were not happy with the food in the home and one felt there could be more activities. The inspector found that service users did not want to make a fuss and therefore do not always pass on their thoughts to staff. The inspector saw evidence of the home’s adult protection policies and procedures. The training co-ordinator stated that the staff team have watched a training video on this subject and then had a general discussion. The inspector saw that the video was present within the home. Two staff confirmed that they had received training in adult protection. The home also has a “whistle blowing” policy and procedure to inform staff how to pass on concerns if they suspect a colleague or management to be abusing service users. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24 and 26 Some areas of the home were well maintained whilst others were not. The home was safe. The furniture in the communal lounges requires replacing as it has become worn and some of it was not safe. There were sufficient lavatories and washing facilities available to service users. Service users’ bedrooms were filled with their own possessions and were comfortable. The home was in need of a general “spring clean” as many areas had become dirty. EVIDENCE: The inspector found a wide range of seating available to service users in both communal lounges, however she found that most of the furniture was worn and frayed, and one seat with a tapestry covering had broken springing. The high seat chairs were in good condition but had food debris and dust encrusted in the seams of the chairs. In one of the lounges there was a coffee table, which had a broken surface. The carpets in both lounges were both badly stained, although the manager stated they were regularly cleaned. The carpet, in one of the lounges next to the television, was puckered. The downstairs bathroom next to the kitchen had grouting broken around the sink and under the mirror, and the bath seat had a dirty deposit on the back of it. The mirror Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 15 was badly mottled. The bath side was loose and coming away. Continence pads were stored at the back of the bath. The second downstairs bathroom was being used to store bedding, some of which was piled behind the bath. The storage shelving in this bathroom was found to be grubby. Bedrooms 1 and 3 were found to have worn carpets. Bedroom 2 had worn head-boards. In bedroom 6 paintwork was flaking off the wall around the sink. Bedroom 11 had a stained and puckered carpet and a chest of drawers had laminate coming off it, the grouting around the sink is coming away. Seating in bedrooms was also found to be in need of cleaning. A commode seat was found to have footprints on it. Two of the upstairs communal toilet facilities were found to have no towels. One toilet closet was found to have a rotting window frame, peeling paint, a badly stained sink, cleaning products were left out and there was no soap or towel. Banisters, stairwells and skirting boards were found to be grubby and in need of washing down and repainting in some areas. The manager informed the inspector that the home does not have a programme of renewal of the fabric and decoration, bedrooms are redecorated when they become vacant. A maintenance man is employed in the home and works two days a week. There was evidence that other areas of the home were in better condition than others. The home has sufficient communal space for service users. The dining room is spacious and was found to be well maintained. The gardens were pleasant and had outdoor furniture for use by service users. The home provides sufficient lavatories and washing facilities Toilet facilities are close to bedrooms and communal areas. Bedrooms were personalised and provided service users with a comfortable environment. All bedrooms were furnished and some rooms had service users’ own furniture. The laundry was situated separately from food preparation areas and housed one washing machine with a sluice wash and a drier. The floor was covered with an impermeable surface. A Health and Safety Notice was posted in the Laundry. The home had a COSHH cupboard (control of substances harmful to health) and policies and procedures were available to staff. The laundry did not have a hand basin but there was one situated in the toilet which was close by. Staff have received training in Health and safety. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were assessed at the last inspection and were all met. EVIDENCE: Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 and 38 Day-to-day operations of the home are overseen by the manager who is well trained and experienced to run a residential care home. The home has an experienced staff team and there is a clear line of accountability within the home. The home is run with the best interests of the service users. The home operates safe working practices. EVIDENCE: Gill Miller has managed the home since 1985, she is a trained registered nurse, midwife and a qualified social worker. Gill shows a commitment to training and has recently completed national vocational training (NVQ) level 4 in care and is studying for the Registered Managers Award. Gill manages the day–to-day running of the home and is supported by a training facilitator and an office administrator. All staff are accountable to Gill, there are no senior staff positions. Gill and the staff team have had training in dementia care and mental health. The home employs seventeen staff, two members that have been there for twenty years. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 18 The home operates an open door policy and details of the home’s philosophy are provided to service users in writing. The inspector observed staff interacting with residents and them to be enabling, patient and respectful. Gill was described by residents as “a lovely person” and staff were described as friendly, helpful and put “themselves out” for you. Visitors at the home were very happy with the care provided and stated that they are always made welcome. One visitor described the home as “friendly, with a homely atmosphere, they have been able to make complaints, which have been acted upon but were not recorded”. Staff informed the inspector that the manager and training facilitator are both supportive. The home holds service users’ meetings every eight weeks. Mulberry House limited have provided the home with a Quality Assurance policy. The manager undertakes an annual audit, last one was April 2004, evidence seen. The home has a complaints policy and procedure, there have been no complaints recorded since the last inspection. The home annually reviews its policies and procedure and has recently introduced a new care planning system and medication system. Service users are able to give feedback through residents’ meetings and inspections. The training facilitator ensures that all staff undertake mandatory training and staff have been trained in Health and Safety, First Aid, Manual Handling, Food Hygiene, Fire Safety. The inspector examined the fridges and found them to be clean. Food was stored in accordance to food hygiene regulations. The inspector saw evidence that the home has policies and procedures in place with regard to all aspects of Health and Safety. The premises are kept locked at night and for short periods during the day, service users are able to come and go as they please. All bedrooms are fitted with locks, in most cases service users prefer not to hold keys. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 1 3 3 x x 2 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x 3 Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 20 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. 1. 2. 3. 4. Standard OP19 OP19 OP19 Regulation 23 (2)(b) 23 (2) (d) 23 (2) Requirement Repair or replace rotten window frames . The premises to be cleaned throughout. The broken table and tapestry chair to be repaired or destroyed Timescale for action 31/10/05 immediate action required immediate requiremen t. 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 OP19 Good Practice Recommendations The home to introduce a refurbishment plan with regard to replacing old and worn furniture and carpeting within the home. Ashwood Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA 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 Rest Home H55-H04 S12397 Ashwood V218549 290605 Stage 4.doc Version 1.30 Page 22 - 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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