Inspection on 05/01/06 for Ashwood Rest Home

This inspection was carried out on 5th January 2006.

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 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 Liz Normanton Unannounced Inspection 5th January 2006 09:50 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.V276851.R01.S.doc Version 5.1 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.V276851.R01.S.doc Version 5.1 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.V276851.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 4 service users in the categories PD(E) May be accommodated at ony one time. 29th June 2005 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 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 DS0000012397.V276851.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second in the inspection year. The inspection took place on the 05/01/06. The inspector was at the home from 9.50am to 2.50pm and met with residents, staff and visitors throughout the day. On arrival the inspector noted that rotting window frames to the front of the house have not been replaced, however, in discussion with the home’s training co-ordinator it was explained that there had been quotes undertaken for replacement window frames. The rotten frames are external damage only and were not seen to be showing signs of rot inside residents’ bedrooms. The registered manager was seen briefly but was unable to spend time with the inspector as she had other plans for the day. The inspector spent time with the home’s training co-ordinator, who assisted the inspector throughout the inspection. Key-standards not audited at the last inspection were the focus of the inspection. The morning was spent in the office discussing residents’ needs, recruitment, supervision, staff training and qualifications. A random selection of residents’ and staff records was viewed. The inspector also spoke with the cook and had a meal at lunch-time to ascertain the quality of the meals provided. The afternoon was spent in conversation with residents, visitors and staff and observing residents and staff interaction. One visitor confirmed that she was happy with the care being provided for her mother since she was admitted last year. She felt her mother’s health had improved and that she has settled well. Three residents stated that the home was well run and one felt unhappy. One resident who has recently moved to the home refused to speak to the inspector. Whilst touring the premises the inspector noted that the fire door from the kitchen was propped open and that the dining room carpet has become worn and was a potential trip hazard. One bedroom was found to have a very strong odour and this was discussed and the matter is being dealt with. Of the seventeen standards audited fifteen were met and two were not. In addition, two further requirements have been added to address the above. What the service does well: There was evidence on residents’ files that need assessments are undertaken of residents and these are reviewed six monthly or as required. However the two most recently admitted residents did not have a needs assessment or care plan on file. The care staff have the individual and collective experience to provide appropriate care to older people. Prospective residents and their relatives/advocates are welcome to visit the home prior to admission. In the likely event of a resident’s failing health leading to death the home respects the resident’s wishes to remain in the home and excellent support is provided to the resident and their relatives. The home provides a varied and nutritional menu with old-fashioned recipes and the occasional continental meal. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 6 Everyone working at the home respects residents’ rights. The home has specialist equipment to benefit the needs of the residents. The home has a well-established staff team with one member of staff having worked there for twenty years. The home’s recruitment policy and procedure promotes the welfare of the residents. Care staff have been given appropriate training to meet the care needs of the residents. Residents’ finances are protected. Care staff have regular supervision, which promotes their knowledge and understanding of residents’ care needs and identifies their training needs. The home keeps records stored appropriately. 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 Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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.V276851.R01.S.doc Version 5.1 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): 3, 4 and 5 Whilst examining residents’ files the inspector noted that there were needs assessments in place, however the two most recently admitted residents did not have needs assessments or care plans on the file. Opportunities are available for prospective residents and their relatives to visit the home prior to admission. EVIDENCE: The inspector viewed six residents’ files and found four to contain a long term needs assessment and care plan. All six files had a photograph of the resident attached. The assessments covered all aspects of care and included a psychological assessment. The two most recent residents admitted had care plan information from social services but no needs assessment or care plan was in the file. The training co-ordinator stated that she was sure that she had done these and could not understand where they had gone. The training coordinator stated that prospective residents and relatives are welcome to come to the home to ascertain if it suits them. They are usually invited to come from 10.00am, stay for lunch and leave mid afternoon. The two most recently admitted residents came as an emergency and did therefore not see the home. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 9 Another resident who has moved in since the last inspection refused to talk to the inspector so their views were not obtained. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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): 11 At their time of death residents can be assured that they and their families will be treated with the utmost respect. EVIDENCE: The home has a death and dying policy and procedure in place. Pain relief medication would be provided as prescribed. The details of arrangements to be made have been provided to the home and are kept in residents’ files. Specialist agencies are welcome to provide practical assistance and advise to staff. Relatives are welcome to stay at the home overnight for prolonged periods of time if necessary. Residents are able to spend their final days in their existing room. Residents’ needs are regularly reviewed and care provided changed accordingly. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 the following standard(s): 15 Residents are offered a varied menu choice and alternatives are available if they do not like what is on the menu. EVIDENCE: The inspector spoke to the cook who informed her that he prepares the lunchtime meal during the week and is occassionally responsible for making the tea. He has produced a three weekly rotating menu, which is reviewed between 3-4 months, in discussion with the manager. He stated that he talks to residents to ask them about favourite meals and keeps a diary of likes and dislikes. There are three meals a day provided which include breakfast, lunch and tea. Drinks and snacks are also provided between meals. Suppertime drinks are also available and a snack on request. The inspector viewed the menus and found them to have wholesome, nutritional and varied meals, some being traditional English meals and the introduction of continental/Asian meals such as lasagne and curry. The cook stated that he would make alternatives if the residents did not like what was on offer. There are three residents who have diabetes and their diet is catered for. The cook makes specialist puddings, which do not contain sugar. The cook buys fresh vegetables every morning and he also uses tinned vegetables. The inspector ate lunch at the home, which was gammon, egg, chips, courgettes and mushrooms. The meal was well presented and was very tasty. Residents’ views about meals were Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 12 varied with some stating they are satisfied, whilst others thought meals could be better. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 the following standard(s): 17 The residents have their legal rights protected. EVIDENCE: The training co-ordinator stated that all residents are on the electoral role. Residents can choose to make a postal vote or attend a local polling booth. Three residents have their affairs dealt with by a “power of attorney”. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 the following standard(s): 22 and 25 Residents have the specialist equipment provided to maximise their independence. The home also has specialist equipment to enable staff to provide care in a safe way. The home has adequate heating, ventilation and provides residents with comfortable surroundings. EVIDENCE: The inspector observed residents moving freely around the building with the use of walking aids. Two residents have their own wheelchairs and the home has four. One resident has an electric buggy for use in the community, and has been supervised to use it to go to the bottom of the street and back to gain confidence in using it. There are handrails fitted in all corridors, bathrooms and bedrooms as required. There are moving and handling belts and glide sheets to assist with transfers. Two baths are fitted with manually operated hoist seats. The home has recently purchased an inflatable cushion, which is used to help people back onto their feet who have had a fall. The mobile library provides talking books on request. All bedrooms have access to natural light and ventilation. Bedrooms have a central light and wall lights Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 15 fitted. Radiators around the home were seen to be fitted with guards. Emergency lighting is provided throughout. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 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 There are sufficient care staff on duty to meet the needs of the residents. Care staff have experience of caring for older people, but the home has not met the target set to have 50 of care staff trained to NVQ level 2 or equivalent by 2005. The home has recruitment policies and procedures to ensure that residents’ welfare is safeguarded, however they need to tighten up procedures as one staff file did not have an employment history on the application form. The staff are trained and competent to meet the needs of the residents. EVIDENCE: The training/ facilitator stated that twelve care staff are employed at the home. A student at Southampton college is also working at the home as part of their NVQ level 2 training, the student is supernumery to the rota. The home also employs a part time maintenance man, cook, cleaner, and administrator. The morning shift is considered to be the peak time and there are three care staff rostered on duty. Two from 7.30am to 4.00pm and one from 8.00am to 4.00pm. Two care staff are on duty from 4.00pm to 8.00pm and there is one waking night and a sleep-in from 8.00pm until 7.30am. One member of staff had rung in sick and the shift was covered as the student was able to provide support to the staff. There are only up to four residents that require total assistance in all aspects of care. The training/facilitator stated that only one member of care staff has completed NVQ level 2. There is reluctance from mature experienced care staff to undertake training. This was confirmed in discussion with a member of Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 17 staff. The manager and training facilitator are aware of the need for training and are looking at ways to encourage staff to embrace life-long learning. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35, 36 and 37 The accounting and financial procedures of the home safeguard the welfare of the residents. The financial interests of residents are safeguarded by the home’s policy and procedure. The training co-ordinator ensures that care staff have regular supervision. The residents’ rights are safeguarded by the home’s record keeping policies and procedures. EVIDENCE: In discussion with the home’s administrator it was apparent that the home is financially viable. Records of financial transactions are kept and all bills are paid. The manager and administrator are appointees for three residents and are responsible for collecting their pensions, subtracting their fees and giving the resident the balance which is personal allowance. Each of the residents has an individual record book. Residents are then responsible for their own personal allowance. The home provides lockable facilities in residents’ bedrooms for the safe keeping of finances and valuables. Four residents are Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 19 supported by “power of attorney”, all other residents’ finances are handled by a relative. The home sends out bills for chiropody, hairdressing, toiletries etc. The training co-ordinator stated that she provides six supervision sessions a year. These can be individual or group supervision and the emphasis of supervision is on meeting the needs of the client. The inspector viewed four care staff supervision notes. One member of care staff confirmed that they receive supervision. Information with regard to residents’ welfare is kept in the downstairs office to enable care staff access to records. Records of financial transactions are kept in the upstairs office and are locked away. Staff records are kept confidentially. Residents can have access to their records on request. Records at the home are kept in accordance with the Data Protection Act 1998. Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x 2 3 3 3 3 x 3 x STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x 3 3 3 3 2 Ashwood Rest Home DS0000012397.V276851.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NONE 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 OP3 Regulation 14 (1) (a) Requirement The registered manager must not provide accommodation to a service user if a needs assessment has not been undertaken. The dining room carpet to be repaired or replaced. The terms and conditions of all new employees must indicate that staff must undertake NVQ level 2 or above as part of their employment. The kitchen fire door must be fitted with a self closing device Timescale for action 30/04/06 2. 3 OP19 OP28 23 (2) (b) 18 (c) (i) 30/04/06 30/04/06 4 OP38 23 (4) (c) (i) 30/04/06 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 DS0000012397.V276851.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW 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 DS0000012397.V276851.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!