Inspection on 26/04/05 for Askham House

This inspection was carried out on 26th April 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

Askham House 14/08/09

Askham House 08/08/07

Askham House 26/07/06

Askham House 20/08/05

Askham House 05/11/04

Askham House 08/06/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

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

CARE HOMES FOR OLDER PEOPLE Askham House Benwick Road Doddington Cambridgeshire PE15 0TG Lead Inspector Shirley Christopher Announced 26 April 2005 @ 10:00 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. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Askham House Address Benwick Road Doddington Cambridgeshire PE15 0TG 01354 740269 01354 741996 n/a Askham Care Homes Limited 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) Mrs Marie Eileen Rankin Care home with nursing 27 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (27), Terminally ill over 65 years of age (27) Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 5 November 2004 Brief Description of the Service: Askham House provides residential and nursing care for up to twenty-seven older people over 65. The property is set back from the road and is approached through a long tree lined driveway. It is set in extensive grounds, with pleasant views across open countryside. There is ample parking space. It is situated on the outskirts of the village of Doddington in a rural setting, within easy travelling distance of the cities of Ely, Cambridge and the town of March. Accommodation is maintained to a high standard, and is tastefully decorated throughout. There is a small sitting area/dining room overlooking a courtyard and a second more substantial lounge with a bar and a second dining room. Most of the bedrooms are single, but there are four double rooms. Bedrooms are provided on ground and first floors and there is a lift to first floor accommodation. The home provides a lunch club to local residents. Transport is provided. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 26 April 2005 over six hours. The home is registered for up to twenty-seven service users, ten of whom were spoken to. A number of relatives were also spoken to. Other methods of inspection included speaking with the registered manager; the registered provider, the administrator and informally interviewing five care staff, one of which was the head of care. A number of records were inspected: staffing records, service user files personal finances, complaints/compliments book, pharmacy report, maintenance records, fire records, accident records and water temperatures. A tour of the home was also conducted. The manager completed a pre inspection questionnaire, which gave basic information about the service. Sixteen relative/visitors comment cards were received by the CSCI and one letter was written in support of the care provided in the home. What the service does well: What has improved since the last inspection? The standards of care provided at Askham House are extremely high, and standards are being maintained. Since the last inspection staffing levels have increased slightly and the registered manager has been given a more Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 6 operational role. She has the overall responsibility for supporting and training staff. A number of overseas nurses are employed at the home and are on an adaptation course. The management structure is clearly organised with a head of care and an administrator. At the last inspection the roof had been leaking. This has been completely replaced and there are plans to completely refurbish the passenger lift. 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. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 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 Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 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) 1,2,3,4,5 Comprehensive pre admission assessments are completed before a trial period is offered at the home. The certificate of registration does not accurately reflect all the care needs met by the home. EVIDENCE: A number of service user files were inspected and included a pre admission assessment and contract. The manager confirmed that newly admitted service users would have a trial period at the home, after which a review would be held to ensure that the home is appropriate to need. Annual reviews are held. Evidence was provided of regular care plan reviews. The inspection reports are available in reception and the manager confirmed that the statement of purpose and service user guide has recently been updated. The Statement of Purpose must state that service users with a diagnosis of dementia are accommodated in the home. The latter is available to service users and their relatives. The manager stated that prospective service users and their families are encouraged to look round the home before admission, but it is recognised that this is not always possible. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 9 The manager confirmed that two named service users have a formal diagnosis of dementia. This is not currently a category on the homes registration certificate and must be dealt with by the way of a variation in respect of these two individuals. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 standard(s) 7,8,10, Care practices in the home are good and are supported by appropriate documentation. EVIDENCE: A number of service user plans were inspected and these provided information about service user’s health, personal and social care needs. Information was provided in sufficient detail and staff spoken to demonstrated a good understanding of the existing service user group. As part of the inspection a number of service users and relatives were spoken to. They commented on how staff met personal care needs. A number of relatives stated that service users were always well groomed and attention paid to their appearance. The activities officer manicured service users nails and the hairdresser visits regularly. Service users spoken to confirmed that they can choose when they go to bed and are given staff assistance as appropriate. All felt that staff were respectful. Staff are regularly updated and receive training appropriate to the requirements of the job, as evidenced through speaking with staff and through inspection of their files. Care staff work in cooperation with external agencies Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 11 to ensure that the health care needs of service users are met as fully as possible. The medication supplies and records were not checked on this occasion. The manager stated that the pharmacist working on behalf of the CSCI carried out a full medication audit in February 2005. The report completed by the pharmacist was seen and the manager stated that any action points had been addressed. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 standard(s) 12,13,14,15 Appropriate social activities are provided, but the frequency of these activities should be reviewed to ensure that the social needs of the service users are given as high priority as their health care needs. EVIDENCE: Twelve service users and two relatives were spoken to about life in the home. Fifteen comment cards were also received by the CSCI. Comments were generally favourable. The home has a fundraising committee who provide money for social activities and trips out. Some service users and relatives felt that planned activities had suffered as a result of the recent departure of the activities coordinator. This was discussed with the manager who stated that someone else had been appointed to the post, which is on a part time basis. Comments made by relatives and service users indicated that care staff work hard but are not always able to spend sufficient time with service users and are always rushing around. Recent activities have included: bingo, manicures, hairdressing, trips out, visits from a brass band, and singers. Raffles are held to raise money and special occasions are always celebrated such as bonfire night and Easter. Families are invited to join in and are always welcome at the home. One relative stated that staff remember birthdays and cards are given out. He stated that there were a lot of activities, but not all the service users were able to join in. At least one Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 13 service user spoken to stated that he chooses to spend his time in his bedroom, but is encouraged to join the others at meal times. One lady attends an Alzheimer’s club outside the home and this may be appropriate for other service users, particularly where they have specific needs/disabilities. The manager has a book of photographs, which shows the activities that have taken place. The menus are displayed on the notice board, but a number of service users spoken to stated that they did not always know what the menu was and it was subject to change. Feedback about the food was positive. The main kitchen is situated in Askham Place, where the food for both services is prepared. Askham house has a small kitchen where drinks and light snacks can be provided. Resident meetings are held, the last documented meeting was March 2005. Service users are consulted about different aspects of life at the home and the files inspected included life stories. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has a satisfactory complaints procedure with some evidence that service users are listened to if they have any concerns. Resident and relative meetings are held and the manager regularly speaks to all the service users to ensure that their needs are being met. EVIDENCE: Staff have received training on adult protection and the home have adequate policies and procedures in place. There is an accessible complaints/compliments book. All concerns however small are recorded. Service users raised a number of small concerns during the inspection. The manager was aware of these and was addressing them. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,23,24,25,26 The environment provides appropriate accommodation, which is homely, spacious and well maintained. The home provides suitable accommodation for service users and is also used by local residents who come to the home for the day. EVIDENCE: A tour of the home was conducted and it was noted that the roof has been completed replaced and there was no evidence of damp. The lift is also to be completely refurbished in July as it has become unreliable. The manager indicated in the pre inspection questionnaire what had altered since the last inspection, which included some refurbishment and replacement of some carpets and flooring. A number of the service user bedrooms were inspected with their permission. One bedroom was sparsely decorated, which the manager stated was the choice of the service user. Others bedrooms were personalised and comfortably furnished. Additional chairs for visitors should be provided. There are a number of double bedrooms, and service users are Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 16 asked if they wish to share. One lady commented that her bedroom was too small. The home was extremely clean and maintained to a high standard. No immediate hazards were identified except for the temperature of the water, in one bedroom. A requirement has been made in respect of this. The building has generous indoor and outdoor space. Service users were able to socialise in small groups or spent time in private. One service user commented that the television was always on in the main lounge. There is a smaller lounge, the Orchard wing. The television was also on and service users confirmed that they could neither hear nor see the television properly. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 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) 27,28,29,30 Staff are employed in sufficient numbers to meet the needs of the service users. Staffing ratios must be monitored closely to ensure that they remain appropriate as service user dependency levels increase. The fullest protection of service users is given through, thorough staff recruitment, retention, training and supervision. EVIDENCE: Five staff were spoken to formally as part of the inspection process. Fifteen relative comment cards were received by the CSCI and several relatives were spoken to at the time of the inspection. Four staff files and the staffing rotas were also inspected. The findings were: The home is fully staffed with the exception of the activity coordinators post, which is for twelve hours a week. A person has been appointed subject to satisfactory CRB and POVA checks. The staffing rotas demonstrated that staffing levels are maintained at all time. A number of comment cards suggested that at peak times of the day care staff were ‘very busy, rushing around and did not always have time to sit and talk to service users.’ The staff interviewed were asked about a typical day and although they acknowledged that at times they were busy, they all stated that they felt there were sufficient staff on duty. On the day of the inspection the NVQ assessor was at the home, which took care staff away from their ordinary duties. This was raised as an issue because of number of service user’s hot drinks had gone cold before care staff assisted them. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 18 ‘Staff files inspected contained all the relevant information as required by the Care Home Regulations 2001 apart from photographs, which were not in two of the files’. The manager was asked to ensure that job applicants provided a written explanation for gaps in their employment, where a full Curriculum Vita has not been provided. Appraisals are held annually and staff supervision every two months. Care staff interviewed confirmed this. The manager stated that all mandatory training was up to date and 40 percent of the care staff have an NVQ qualification. Five staff are currently studying for an NVQ training. Recent training undertaken by staff in addition to the mandatory training included: a diploma in infection control, peg feeding, managing aggression, Parkinson’s disease, care of the feet, duty of care, ACAS, clinical governance and strokes. Staff interviewed confirmed that they had participated in recent training and received regular support and supervision. They also regularly attend staff meetings and felt that the manager and head of care were approachable. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 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) 31,32,33,34,35,36,37,38 EVIDENCE: The staff spoken to were clear of the boundaries of their responsibilities and had clear job descriptions. Relatives, service users and staff felt that the management team were supportive and highly visible. The home employs a full time maintenance person, who also drives the home’s vehicle. A number of records were inspected and were mostly satisfactory. Thermostatically valves are fitted. However in one bedroom sink the water temperature was extremely hot. The manager was asked to test the temperature, and it exceeded 43 degrees. The manager was asked to adjust the temperature accordingly and to ensure that water temperatures were tested correctly. Records showed weekly testing of water temperatures, but Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 20 the water was not being run long enough thus giving an incorrect temperature reading. Fire records were satisfactory. Staff training in health and safety has been provided and appropriate risk assessments covering key activities were said to be in place although not inspected. The manager provided maintenance records for the hoists and lifts. She confirmed that the last electrical inspection was on the 3 April 2004, the gas safety certificate is issued yearly and portable appliance testing is carried out yearly. The manager stated that accident statistics are monitored monthly and steps are taken to reduce preventable risks. A high number of service users have bed rails, but not all of them have protective bumpers. This is to be reviewed. A number of service user’s finances held by the home were checked and found to be accurate. Service users manage their own finances or relatives manage them. The home hold small amounts of personal finance, which is properly audited and receipts kept. The Registered person confirmed that audited accounts are kept but these were not inspected. Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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. 1. Standard 1 Regulation CSA 2000 Requirement The home must apply for a variation to their registration certificate for two existing named individuals who have a formal diagnosis of dementia. The Statement of Purpose must accurately reflect the categories of service users accommodated in the home. Water temperatures must be recorded properly and be maintained at 43 degrees or less in service users bedrooms and communual bathrooms/toilets. Timescale for action 30 July 2005 2. 1 4 30 July 2005 with immediate effect. 3. 25 13 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 12 Good Practice Recommendations Suitable social activities are provided, but the frequency of these activities should be kept under review and some service users may wish to pursue interests outside the home. This should be facilated and encouraged. Service users should be able to meet visitors in the privacy of their own bedrooms. Chairs should be provided for this. I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 23 2. 24 Askham House Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 Page 24 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Askham House I53 I03 S24321 ASKHAM HOUSE V214062 260405 STAGE 4.doc Version 1.30 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. 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!