Inspection on 09/06/05 for Ayrshire House

This inspection was carried out on 9th June 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ayrshire House 30/01/07

Ayrshire House 19/10/04

Ayrshire House 14/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Ayrshire House 24-26 Main Road Long Bennington Lincolnshire NG23 5EH Lead Inspector Julie Western Unannounced 9 June 2005 09.30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ayrshire House Address 24-26 Main Road Long Bennington Lincolnshire NG23 5DH 01400 281971 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) Ms Sarah Wright Ms Sarah Wright Care Home 15 Category(ies) of Learning Disability (LD) - 12 registration, with number Learning Disability - over 65 (LD(E) - 3 of places Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/10/05 Brief Description of the Service: Ayrshire House is a listed Georgian building with a large garden, situated on the main road running through the village of Long Bennington and in close proximity to the village shops and pubs. There is a church, a village hall and a medical centre and the home has a mini-bus to provide transport for residents, Newark and Grantham being approximately 5 and 8 miles away. The home is registered to provide care and accommodation for up to 15 residents with a defined mental health need, three of these being over 65 years, in two shared and eleven single rooms, on three floors. On the day of the inspection the home was fully occupied. This is a family-run home, with the Owner/Manager working in the home; on the day of the inspection the Deputy Manager was on duty and was present throughout the inspection. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussion with the residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Three of the fifteen residents and two of the care staff were spoken with. The Deputy Manager was present throughout the inspection. What the service does well: What has improved since the last inspection? The first floor bathroom on the first floor and one of the resident’s rooms have recently been redecorated and the ground floor corridor has been primed ready for decorating. One of the residents has started attending an advocacy group facilitated by the Social Education Centre, where opinions and views of service users are shared; she is taking the minutes at the next meeting. The complaints procedure has been amended to include a statement that all complaints would be addressed within 28 days and the senior carer on each shift is now identified on the staffing rota. Staff have recently been attending training sessions on the ageing process and dementia, in the light of the increasing number of older residents. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-4 The home clearly sets out what it intends to do for its residents and this information is freely available. The service user guide would benefit from being in an alternative format. EVIDENCE: There is a comprehensive statement of purpose that tells the service user and their relatives what they can expect from the service and that there will be an assessment process to undertake prior to a service being provided. The service user guide is not available in an alternative format, such as a video, or the use of photographs or Makaton pictures. Assessments prior to admission were in each resident’s care records and showed that residents, their relatives and other professionals were involved and contributed to the care plans. They contained details about health care, mobility, leisure and nutritional needs. The home demonstrates its capacity to meet identified needs by way of staff training and the conduct and management of the home Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6-10 Service users benefit from a person centred approach to care and support, which enables them to develop their independence in a safe and supported manner. Risk assessments need to be reviewed. EVIDENCE: Care plans seen contained details about how residents expressed their needs and showed that they were encouraged to make decisions for themselves wherever they were able. Staff members demonstrated that service users were encouraged to make decisions as part of the everyday support offered; for example residents were asked what they wanted to do and what they wished to eat. Risk assessments were contained in care plans for issues such as road safety and making hot drinks, but needed updating. Care files were well organised and the layout was consistent. All records were kept in a lockable cupboard and staff demonstrated their understanding of confidentiality issues throughout the inspection. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Service users enjoy a full and appropriate range of activities both in the home and in the local community. They benefit from the promotion of self-help skills; and clear care records underpin the care and support provided. EVIDENCE: Likes and dislikes sheets were included in all care plans and clearly show the preferences of residents, including diet, weekday and weekend activity. A care plan from the Social Education Centre attended by most residents also provided full details of the residents’ pastimes and activities. There was evidence in care notes of leisure activity such as coffee mornings, meals out and visits to pubs. There was also evidence of in house activity such as art materials, entertainers, videos and books. Service users were being encouraged by staff to undertake activities such as shopping, cleaning their rooms and ironing. Residents also accompanied staff on shopping trips to the supermarket. Records demonstrated that menus are planned retrospectively and based on residents’ needs and preferences. Residents said they enjoyed the food provided and some assisted with preparing the evening meal. The atmosphere at breakfast was relaxed and informal. Future events included a barbecue in July, a fete in August and a holiday in September, depending on the residents’ choice of destination. Care plans showed that some residents Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 11 had regular contact with relatives, including trips home at weekends. Relatives were encouraged to take part in events such as the barbecues. A daily log gave details of residents’ daily activities. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18-20 The home’s records give a clear picture of the personal and health care needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: All residents in the home were fully mobile; however personal care was given in the form of assistance with bathing a showering and one resident had a stoma bag, which was managed by staff. The local GP visited all residents annually and the district Nurse visited annually to administer the ‘flu vaccine. Accident records showed that there had been no serious injuries to resident in the last twelve months. On the day of the inspection the pharmacist visited to carry out a check on medication; this was satisfactory. The home used a wallet system to administer medication and only senior carers were able to carry out this duty. No residents were able to administer their own medication and several residents did not take regular medication.. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: The compliments, concerns and complaints book showed that there had been no complaints over the last twelve months. The home had an up to date copy of the Local Authority Adult Protection Procedures but did not have a copy of the No Secrets document. Residents said they would go to the Social Education Centre or the Manager if they had a complaint and staff were knowledgeable on adult protection procedures. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-27,30 The residents live in a comfortable, pleasant and safe environment with both x private and communal space being generally suitable for their needs. EVIDENCE: A tour of the premises showed that the building was well maintained internally and the gardens and grounds offered a pleasant place for residents to sit out in good weather. The Manager carried out a health and safety check annually; this included a risk assessment of the building. The building is spacious and there is a large activities room, which is used for meetings and indoor entertainment; it contains some keep-fit equipment for the use of residents. Ongoing maintenance included the recent redecoration of the first floor bathroom and the doors in the corridor had recently been sanded prior to repainting. A resident showed the inspector her room, which had recently been decorated. A bathroom shower needed some attention to the wall and skirting board and the main lounge, which is used by smokers, was l in need of redecoration. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36 There is an appropriately trained and supervised staff team who are able to meet service user’s needs. The home maintains appropriate staffing levels and the service users benefit from a stable and consistent team. EVIDENCE: The home benefits from having a very stable staff group, some staff members having been at the home 20 years. Staff files do not contain up to date photographs,. There is evidence that supervision for staff is undertaken at least 4 to 6 weekly, with an annual appraisal. Staff members had a clear understanding of their roles and responsibilities. The residents were very positive about the care they received from the staff. One said ‘I like all the staff’. The most recent staff member to be appointed confirmed that she had given two references, which were followed up, a CRB check and undertaken an induction programme before commencing work. Training records showed that statutory training was completed with recent specialist training being in dementia. Two staff members had the National Vocational Qualification at Level 2 with two currently undertaking it and a further three had the NVQ at Level 3 with two working towards it. Minutes of the recent staff meeting were available for all staff. The staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were staggered to accommodate the needs of residents. Residents spoken with thought there were enough staff and staff confirmed this. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41 Residents and staff benefit from an open and supportive management approach. The home is well managed ensuring that service user’s health and safety is maintained, whilst promoting their independence. Records are well maintained. EVIDENCE: The home has a range of policies and procedures e.g. infection control, health and safety, moving and handling, fire safety and Legionella controls. Risk assessments for the environment were seen and individual service user risk assessments were contained in personal files. Fire records were satisfactory, materials included in Control Of Substances Hazardous to Health regulations were stored appropriately and data sheets were available. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ayrshire House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 2 x x C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 18 none 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 YA1 Regulation 5,16,Sch2 [4] 13[4] 16[1][2][ c] Requirement The registered person must develop a service user guide that is easily understood by adults with a learning disability. The registered person must ensure that risk assessments for service users are The registered person must review locks on bedroom doors to ensure that they are safe and maintain privacy and dignity while allowing staff to access in emergencies. The registered person must redecorate the living room and the lower wall and skirting of the ground floor bathroom shower The registered person must develop an up to date training plan Timescale for action 8th August 2005 8th August 2005 8th August 2005 2. 3. YA9 YA24 4. YA26 23[2][d] 8th August 2005 8th August 2005 5. YA41 12[1]18[1 ] 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 YA23 Good Practice Recommendations It is a recommendation that the home obtains a copy of C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 19 Ayrshire House the No Secrets document published by the Department of Health. Ayrshire House C53 C04 S2322 AyrshireHouse V231997 090605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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. 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