Inspection on 21/02/07 for Astbury Lodge

This inspection was carried out on 21st February 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

Astbury Lodge 03/03/06

Astbury Lodge 14/09/05

Astbury Lodge 23/11/04

Astbury Lodge 11/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Astbury Lodge Randle Meadow Hope Farm Estate Great Sutton Cheshire CH66 2LB Lead Inspector Paul Ramsden Unannounced Inspection 21st February 2007 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 Astbury Lodge DS0000006520.V325850.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. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Astbury Lodge Address Randle Meadow Hope Farm Estate Great Sutton Cheshire CH66 2LB 0151 355 7043 0151 356 9025 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) www.clsgroup.org.uk CLS Care Services Limited Mrs Jenny Ringstead Care Home 42 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (9), Old age, not falling within any other of places category (32) Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This service is registered for a maximum of 42 services users to include: * Up to 32 service users in the category (OP) may be accommodated * Up to 9 older service users in the category of DE(E) may be accommodated in the Meadows Unit * One service user in the (DE) category may be accommodated in the Meadows Unit 3rd March 2006 Date of last inspection Brief Description of the Service: Astbury Lodge is a two-storey care home for people over 65 years of age; access between floors is via a shaft lift or the stairs. The home is owned by CLS care services, a registered charity and is located in Ellesmere Port. It is close to the local shops and other community facilities. There are a variety of garden and patio areas available for residents; these are accessible and well maintained. The home is registered to provide care for up to 32 older people and ten older people with dementia who have their own separate accommodation, the Meadows unit. Residents accommodation consists of 39 single and one double bedroom. Three of the single bedrooms have en-suite facilities; the remaining rooms have wash hand basins fitted. There are a variety of lounge and dining areas with drink making facilities provided for residents. Astbury Lodge has an adequate number of toilets and a variety of bathrooms available. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee range for the home is £415 - £495 per week. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 21 February 2007 and lasted 7 hours. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire in order to provide up to date information about services in the home. Questionnaires were made available for residents and families to find out their views and other information received since the last key inspection was reviewed. During the visit various records and the premises were looked at. A number of residents, relatives and staff members were spoken with; they gave their views about the home and the service provided. The home manager is currently on a period of sabbatical leave and one of the care team leaders and the home services manager are managing the home in her absence. The CSCI have been kept fully informed about these proposals and have agreed to the temporary arrangements. No issues regarding this were seen on the day of the visit. What the service does well: What has improved since the last inspection? The new care planning system has now been fully implemented. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 6 A number of areas within the home have been redecorated and refurbished. 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. Astbury Lodge DS0000006520.V325850.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 Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to residents; some of this is in a guide called, “Welcome to Astbury Lodge”. This contains all of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People. During the visit two visitors looking for a home for their mother confirmed that they had visited unannounced and had been made to feel very welcome. As part of the inspection process the care files of three people living at the home were looked at. Pre-admission assessments demonstrating that a resident’s individual needs were being assessed in an accurate and consistent Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 9 way had been carried out. Senior staff members with input from the resident [where possible] and family members undertake the assessments in order to identify specific individual needs before a service is provided. Where applicable the assessment documentation provided by the placing authority was also seen on the files. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care team leaders are responsible for drawing up a resident’s plan of care, those seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. There was written evidence to confirm that care plans were being reviewed monthly and where necessary rewritten. The care plans are also audited regularly by the acting home manager and care team leaders. Residents or their families/advocates are involved in the care planning process. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 11 Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. During the visit the staff members were able to demonstrate that they had the ability to deal with an emergency situation when one of the residents had a fall in the lounge/dining room; the staff on duty responded immediately but calmly, making sure the person maintained there dignity and that there were no injuries. Luckily there wasn’t and the person was assisted into an armchair. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. CLS has a written policy on the receipt, administration [including selfadministration] safekeeping, handling, recording and disposal of medication within its homes. The home uses a blister pack system dispensed by a local pharmacist. No obvious issues were seen during the inspection visit. The preinspection questionnaire gives the names of those staff members who administer medication. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. Staff members were seen to knock on the door and to await permission before entering a resident’s bedroom. The home has two experienced activities co-ordinators whose roles are to work with residents, both individually and in groups. One of the co-ordinators takes the lead role in arranging social and other events in the main home and the other works in the Meadows unit. A wide variety of social and other activities are organised and information about these was displayed on the notice board and throughout the home. A string quartet had played in the home the Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 13 previous day and the residents spoken with said that they had thoroughly enjoyed their performance. They also made a number of positive comments about the other events/activities available. A computer, with Internet access is also available for residents if they wish to use it. Links with the local community are maintained and people are able to come and go from the building, one of the residents goes to the local pub every day. Visitors are free to visit the home at any reasonable time. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be taken in the dining areas or in the privacy of residents’ own rooms. There is a five-week menu that has the flexibility to meet individual needs and choices; special diets can be prepared where necessary. All of the residents that commented said the food was good and that they could make choices. The record of food actually chosen by residents was seen during the visit; this confirmed that the kitchen staff had a good understanding of each individual’s likes and dislikes. The Meadows unit has its own kitchen; this gives the staff members and residents a choice of whether to cook a meal in the unit. Cheshire County Council environmental health team has awarded the home the title; “Best CLS Cheshire Home 2006/07 Food Safety Audit”. This is displayed in the entrance area. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear complaints procedure for the home; leaflets about complaints and the procedure that will be followed are available in the entrance area. This is also included in the welcome guide. The pre-inspection questionnaire indicates that six minor complaints have been received during the previous 12 months; these were all responded to within the agreed timescale. The residents and relatives spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. One of the care Team Leaders has lead responsibility for training staff members in this area. During the visit the content of this course was discussed; whilst it covered the various types of abuse that can occur it did not appear to provide clear details about the adult protection procedures to be followed should an incident arise. This was discussed with the care team leader responsible for the training and the home services Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 15 manager. They agreed to address this issue immediately. A requirement regarding this has therefore not been made. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included the lounges, communal areas and a number of bedrooms. Furnishings, fittings and lighting in the lounges and communal areas are of a good quality and are domestic in character. Since the last inspection visit a number of areas have been redecorated and some new lounge furniture has been bought. Bedrooms seen during the inspection were personalised, comfortable, wellfurnished and contained items of furniture belonging to residents’. The home provides adaptations for use by residents with mobility problems: these include bath and toilet aids, hoists, grab rails and wheelchairs. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 17 The home was found to be clean and tidy on the day of the visit. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Ellesmere Port and Neston Environmental Health Department has recently awarded the home a “Gold Award” for high standards of hygiene and safety. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and relatives spoken with were complimentary about staff attitude and competence. A relative said, “The staff are very friendly and helpful”. The pre-inspection questionnaire shows that 14 of the 33 care staff members are qualified to NVQ level 2, a recognised qualification for staff involved in delivering care. The files for three recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 19 New staff members undertake the Skills for Care induction-training programme. Copies of induction records were seen on the day of the visit. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that residents are safe. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She has completed the registered managers award and has attended courses/training in order to fulfil her management responsibilities. She is currently on a period of sabbatical leave and one of the care team leaders and the home services manager are managing the home in her absence. The CSCI have been kept fully informed about these proposals and have agreed to the temporary arrangements. No issues regarding this were seen on the day of the visit. Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 21 A quality assurance survey to ascertain whether residents and families are happy with the standards of care being provided was undertaken in September 2006. The results are on display in the entrance area. Comment cards and a feedback box, also located in the entrance area are available for people to use if they wish to do so. Residents’ personal allowances are being handled appropriately. Personal monies were being kept securely and those inspected had correct balances and accurate records. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. There was evidence that staff were receiving training in areas such as moving and handling, first aid and adult protection. There is a record of all of the training undertaken by staff members; these were seen during the visit. In addition to these records CLS have recently introduced a new computerised training database called Resource Link; this will list the training undertaken by staff and “flag up” when the training needs to be updated. All staff members have a supervision file and there was evidence to confirm that they were receiving regular one-to-one supervision. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. All of the maintenance contracts seen were up to date. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 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 3 3 X X X 3 3 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 3 X 3 X 3 3 X 3 Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Astbury Lodge DS0000006520.V325850.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!