Inspection on 08/08/07 for Askham House

This inspection was carried out on 8th August 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

Askham House 14/08/09

Askham House 26/07/06

Askham House 20/08/05

Askham House 26/04/05

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 Alan Buttery Unannounced Inspection 8th August 2007 10:00 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 Askham House DS0000024321.V346153.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. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Askham House Address Benwick Road Doddington Cambridgeshire PE15 0TG 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) 01354 740269 01354 741996 www.askhamcarehomes.com Askham Care Homes Limited Mr Salim Giga Mrs Marie Eileen Rankin Care Home 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 DS0000024321.V346153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 8 Beds Personal Care 1 named adult under 65 years of age with a Mental Disorder Date of last inspection 26th July 2006 Brief Description of the Service: Askham House is situated just on the outskirts of the village of Doddington. From this rural location there are good road links to the Cities of Cambridge, Ely and the nearby town of March. Accommodation is offered on two floors in mostly single bedrooms. There are four double bedrooms. The home can accommodate up to twenty- seven service users, with a residential or nursing need. The home is comfortable, spacious and well maintained. It has a number of small sitting areas and a living room/dining room facing a small courtyard garden. The home has a third, more spacious lounge, with a bar and overlooking extensive gardens. This is also used for the provision of day care for local residents. There is also a further dining area. The home is approached through a long, private tree lined drive leading up to the main house. There are ample gardens and acres of land belonging to the owners of Askham House. On the same site is a second home belonging to the owners, but managed entirely separately. This provides accommodation to adults with physical disabilities and who may require nursing. The two homes share a main kitchen, and food is brought over to Askham House on heated trolleys. Askham House has a small kitchenette for the preparation of drinks and snacks. The weekly fees are between £343 and £650 at the time of the inspection. There is a notice in the main hall stating when the last inspection was and that there is a report available, and a copy of the report was seen on a table in the inner hallway. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit, and looked at the key minimum standards for older people. The registered manager was on annual leave, and one of the registered nurses provided the required information and documentation. A second visit was made to look at staff records, which were in a locked cabinet, accessed by the service’s administrator, as well as the manager. An annual quality assurance assessment has been submitted to the commission, and is reflected within the report. 27 people currently live in the home, 19 of them in individual rooms, and the remaining 8 in 4 shared rooms, which is a long standing arrangement. There is currently 1 staff vacancy, but the recruitment process is well underway to fill this post. What the service does well: What has improved since the last inspection? New garden furniture has been provided for the courtyard area. The service continues with an ongoing programme of redecoration and improvement. Other improvements detailed within the annual quality assurance document include management training in IT, improved medication audits, more residents meetings and more specialist equipment provided. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Askham House DS0000024321.V346153.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 Askham House DS0000024321.V346153.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): Standards 3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Detailed information is obtained prior to anyone moving to the home to ensure that identified needs can be met. EVIDENCE: Before any one new moves into the home, a detailed admissions procedure is followed. A brochure would initially be sent to any prospective new admission, detailing the facilities of the home, fee levels and general information, together with an initial application form. If the initial enquiry proceeds, the manager and/or a senior carer would then complete a home visit, or visit to the prospective new resident in hospital to complete a pre admission assessment. Where a local authority funds the care, copies of their assessments are also obtained. The information gathered would be used to identify the needs of the person looking to move into the home, and ensure that they were able to meet those needs, and the documentation used was seen on three files examined for Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 9 people living in the home. It is important that all the required information is gathered, for example one file seen did not have a social history, another no date of birth, although this was available elsewhere. The service does not offer intermediate care. Askham House DS0000024321.V346153.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Detailed care plans are in place to ensure that the service users can be assured that their needs are met. EVIDENCE: Individual care plans are available for all the people living in the home, and examples of these were seen for three of the people living in the home. The care plans offer instruction to staff in the delivery of care and support, and evidence was available that the care plans are kept under review. One care plan examined did not include any plan for social activities which should be addressed. The care plans examined were all signed by the individual, and the senior carer confirmed that the plans are discussed with the person they relate to when they are written and at reviews. The service ensures that the individual’s health care needs are met, ensuring that GP and district nurses are available when required, and that people living Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 11 in the home have access to a range of other professionals including dentists and opticians. Nutritional advice is available from dieticians, and staff are trained in assisting people with feeding, including Peg feeding. The service has a detailed medication policy, and qualified nurses administer medication. Records were examined and were in order. One person living in the home is able to manage her own medication, and keeps it stored in a locked cabinet in her room. A care plan was in place to support this, but no risk assessment had been done, which should be available. Staff treat the people living in the home with dignity and respect at all times, and were seen to knock on doors before going into someone room, and they interact in an appropriate manner. The senior carer also said that care staff always ask people what they want to wear when helping them to get dressed. Askham House DS0000024321.V346153.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): Standards 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home are able to choose from a variety of events and activities, and regular residents meetings ensure their views are taken into account. EVIDENCE: A range of events and activities are available to people living in the home, and a former member of the management team now co-ordinate activities, working four days a week. The annual quality assurance assessment indicates that people living in the home are involved in planning activities and events through regular resident meetings, which are minuted by someone living in the home who is a former secretary, and a monthly newsletter keeps everyone informed as to futures events and plans. As a qualified nurse, the activity worker has also introduced some ‘healthy activity’ including some exercises and passive physiotherapy. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 13 Wherever possible, people living in the home access the local facilities and the village community, and this is something they are looking to develop further in the coming months. A varied menu is available, with at least two choices of main meal, and soft or liquidised diets available as needed. Breakfast and tea is prepared in home’s small kitchen, but the main meals are cooked in the home next door, owned and operated by the same provider, and brought across on hot trolleys. A variety of breakfasts are available including cereals and fruit, and a cooked breakfast was on offer, but the people in the home suggested they would prefer this as an option at teatime, so this was changed. Askham House DS0000024321.V346153.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): Standards 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure any concerns or allegations are dealt with. EVIDENCE: The home has a clear complaints policy, and a copy is available to all people living in the home in their service user guide. Complaints are recorded in a complaints log, which was seen during the inspection. The home has not received any significant complaints since the last inspection and none have been received by the Commission. A comments and suggestions box is available in the main hall for people to use, and regular residents meetings give the people living in the home the chance to raise any comments they may have. The service follows the local authority adult protection policy, and all staff receive regular adult protection training, normally using the local authority trainer. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides a homely style of living in pleasant and clean surroundings, with well maintained gardens, accessible to everyone living in the home. EVIDENCE: The service provides a pleasant environment both inside the home and in well maintained and spacious gardens. Up to three domestic staff are available to keep the home clean together with a gardener. The home also has an enclosed courtyard area with seating, with new tables and chairs, and shaded sitting areas in the garden. The entrance to the home is in need of maintenance, with an uneven concrete area which is difficult to push wheelchairs over. On the day of the inspection, the home was clean and tidy and free from unpleasant odours. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Recruitment and training procedures ensure a well trained staff team are available to support the people living in the home. EVIDENCE: The service employs a good mix of staff with the necessary skills and experience to meet the needs of the people living in the home, and also supports student nurses, social workers and health and social care students on placement. A thorough recruitment process is followed, and was evidenced on the staff files examined, with the necessary application, references and checks all in place before anyone starts working in the home. It was noted that the references are not all verified, and the format in use did not have a space for the referee to date the form, which would improve the audit trail available. All staff receive a variety of training, both mandatory and specific to the people they support in the home, and records of the training provided were seen on the files examined. The service has also supported NVQ training for its care staff, with over 90 of the carers having achieved NVQ level 2 or above. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 17 During the visit the inspector spoke to three of the care staff working, and all appeared very happy with the support and training they receive, and very committed to the job they are doing, and were able to detail some of the training they receive,. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. An experienced and stable management team ensure the service is run efficiently and for the benefit of those living there, and health and safety policies and procedures ensure the safety of both staff and residents. EVIDENCE: Someone with many years of experience manages the service, and both staff and people living in the home commented on the excellent manner in which the home is run. The proprietor visits the home regularly, and is available at all times if needed. Together with an experienced administrator, this provides a strong management team. All the necessary maintenance checks are being done on a regular basis, together with health and safety training and risk assessments on the premises. Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 19 As already indicated, regular residents meetings are held, to enable the views of the people living in the home to be included in future planning, and in addition staff meeting give the people working in the home opportunity to contribute. Staff all receives regular supervision and an annual appraisal Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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 X X 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 2 X X X X X X 2 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 3 X 3 X 3 X X 3 Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 21 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. 1 Standard OP19 Regulation 23(2)(b) Requirement The registered provider must ensure the entrance to the home is safe and suitable for people with mobility difficulties Timescale for action 31/10/07 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 OP7 Good Practice Recommendations Individual plans should include all areas of peoples lives, including social activity Askham House DS0000024321.V346153.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cambridgeshire and Peterborough Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Askham House DS0000024321.V346153.R01.S.doc Version 5.2 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. 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