Inspection on 16/11/05 for Glenwood Nursing Home

This inspection was carried out on 16th November 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

Glenwood Nursing Home 08/01/09

Glenwood Nursing Home 09/01/07

Glenwood Nursing Home 02/08/05

Glenwood Nursing Home 22/12/04

Glenwood Nursing Home 21/06/04

Glenwood Nursing Home 26/02/04

Glenwood Nursing Home 23/12/03

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Ashwood Nursing Home Ashwood Mental Nursing Home Liverpool Road Widnes Cheshire WA8 7HJ Lead Inspector Anthony Cliffe Unannounced Inspection 16th November 2005 09:00 Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashwood Nursing Home Address Ashwood Mental Nursing Home Liverpool Road Widnes Cheshire WA8 7HJ 0151 420 5945 0151 420 5945 ashwood@c-i-c.co.uk 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) Community Integrated Care Mrs Joan Knight Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to be accommodated as follows:6 Service Users may be accommodated within the Ashwood Unit 6 Service Users may be accommodated within the Glendale Unit 2nd August 2005 Date of last inspection Brief Description of the Service: Ashwood is a care home with nursing providing care for 12 people with learning and physical disabilities.Ashwood/Glenale is owned and managed by Community Integrated Care, which is a non-profit making organisation. The home is located in the Ditton area of Widnes, near to shops, pubs, post office, and other local amenities. It has a small parking area and a garden area with patio to the rear of the property.The home comprises of two purpose built dormer bungalows, but only the staff offices, staff toilets and staff sleep in rooms are situated upstairs. All the bedrooms are on the ground floor and all have fitted furniture and a wash hand basin. There are no en-suite facilities, but there are 4 assisted bathrooms and separate toilets on the ground floors.Also on the ground floor are two large lounge / dining rooms, two kitchens and utility rooms. The home isn in a local bus route and close to two local railway stations. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours. It included inspection of records, observation of staff practice and discussion with residents with the aid of staff and discussion with staff. Feedback was given to the manager at the end of the inspection. A requirement from the last inspection visit has been amended to a recommendation due to the improvement in the testing of fire equipment. What the service does well: What has improved since the last inspection? Management of the staff team continues to improve with leadership and guidance improving. More fulltime staff has been employed with less reliance on agency staff and additional staff provided on both units throughout the day. Staff moral has improved and staff comments reflect this. The home has undergone some refurbishment, including ceiling mounted hoists fitted to two residents’ bedrooms. Residents care plans have been reviewed to reflect their changing needs. Staff awareness of the local authority adult protection procedures has improved through staff training. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 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. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 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 the following standard(s): None of theses standards were assessed. EVIDENCE: Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 9. Residents’ needs, aspirations and decisions about their lives are reflected in their care plans. Residents’ health and safety needs do not hinder them leading an independent lifestyle. EVIDENCE: Residents’ care plans contained comprehensive risk assessments and risk management plans to manage residents’ health and social care needs. Risk assessment strategies were in place regarding a residents’ mental health and physical health needs taking account of assessment and information from other professionals involved in the residents’ care. Residents’ essential lifestyle plans were detailed and recorded their individual wishes about the care they received. An example was a resident identified with severe cognitive impairment had his choices about how he wished to be cared for recorded. Records detailed that he recognised he was unable to make decisions independently and needed support to do so. His essential lifestyle plan recorded his wishes and aspirations. Details of his preferences of food were noted. He required a soft diet with food thickened with a staff member to assist him eat his meals. He enjoyed his food portions separately so he could enjoy the different flavours. There was details of the resident’s review of his needs during a period of ill health when he needed a chest x ray and regular monitoring by a general practitioner. There was a review of the resident’s mental health needs that recognised that the resident’s cognitive abilities were Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 10 deteriorating. A decision was recorded on behalf of the resident that he wished to spend more time in his bedroom and when receiving personal care. There were a number of risk assessments in place to support the resident in and outside of the home. These related to the resident’s needs around transport and assisting staff in the kitchen. The resident could not actively participate in meal preparation but enjoyed being with staff and contributing to the choice of meal being prepared. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 13,15 and 16. Residents are able to participate in their local community. Residents take responsibility for their lifestyle choices and maintain positive relationships. Residents’ responsibilities for life choices are recognised. EVIDENCE: Ashwood care home is situated in the Ditton area of Widnes and central to local amenities. Residents’ care plans detail their involvement in the local community and the places they enjoy visiting. A resident enjoys going to a coffee shop. Three or four times a week, and his records describe that he becomes agitated if he does not go out. Another resident enjoys going to the local shops to buy personal items and has developed a relationship with staff in the shops. The resident’s care plan details that he does not understand the concept of money and staff support him to pay for items purchased and ensure he has the correct money to give to staff. Residents essential lifestyle plans are written from the residents’ perspective and record their wishes, choices and aspirations. A resident’s care plan detailed that he has a ‘great sense of humour and infectious smile’. The resident is recognised, as being independent is areas of his life and can show staff what he wishes to do by taking them to the places or items he needs. The resident likes to groom himself and his bedroom has been adapted to suit his needs. The resident is recognised as having important relationships with family, other residents and staff. He enjoys Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 12 communicating with people and had aids to support his communication, which staff encourages him to use. He enjoys music and has his own musical instruments. The resident choose his own leisure activities such as going out for a coffee and a meal. The resident has aids to support him in eating his meals independently. Another resident’s essential lifestyle plan detailed that the resident had no family and his aspiration was ‘to live in my own home with people I like’. The resident recorded his wish that ‘staff must treat me like other people and make sure my needs are met by following my care plan’. The resident’s care plan recorded he enjoyed aromatherapy and a massage. He also enjoyed going out for walks and for meals but did not like crowded places that upset him. It was recorded that he enjoyed ‘the snoozelun, a well maintained wheelchair, few staff changes as possible and shopping for clothes’. Three of the residents have lived together for many years. Following assessment by relevant professionals it has been identified that the residents require personal care only and can live more independently. Their wishes to live more independently are recognised in their essential lifestyle plans. These have been reviewed annually and arrangements are in place for the residents to move to their own house. As part of this process an independent advocacy service has been approached to support the residents through their move to independent living. A resident who is identified as moving has the support of his family and their wishes about this are recognised and supported by staff at Ashwood. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19 Residents are supported to maintain their health and welfare. EVIDENCE: Residents’ health and emotional needs are met with staff support. There were examples of residents being referred to specialist NHS services and treatment and advice from staff in the local Primary Care Trust. A resident is regularly reviewed by a speech and language therapist for swallowing difficulties. The advice from the speech and language therapist is recorded as part of the resident’s care plan. Residents have detailed health action plans, which identify how their medical needs are met. The include details of the professionals involved in their care. This includes annual health checks and appointments with the dentist and chiropodist. Residents’ records detailed contact with general practitioners when residents’ health needs deteriorated. The ‘Ok Health Check’ for a resident detailed her health needs and medication prescribed for a medical condition. There were details on the side affects of medicines she was taking. The resident was noted as having epileptic seizures and there was guidance for staff to follow in the event of the resident having a seizure. The resident used a walking aid and her mobility was reviewed. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 23 Staff awareness and training on the local authority adult protection procedures has improved to ensure residents are protected from abuse. EVIDENCE: The staff team had training on the registered providers adult abuse policy and procedure in April 2004. The manager has cascaded this training to staff as recommended at the last visit. Three staff interviewed confirmed they had received this training. This had taken part in small groups with the manager were they watched a video and completed an accompanying workbook on the local authority procedures. The manager said that he had followed up the training in supervision and verified that staff had read the local authority procedures. Staff confirmed the adult protection procedures had been discussed. Recently appointed staff confirmed adult abuse training was included as part of the registered providers induction training. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24, 26, 28, 29 and 30. Residents live in a comfortable, clean and safe environment, which is equipped to meet their needs and promote their independence. EVIDENCE: Ashwood care home is well maintained and safe. The construction of a link corridor to connect both units at Ashwood has commenced. This does not include additional private wheelchair accessible facilities for residents as recommended at the previous visit. Due to this residents do not routinely attend reviews of their care as these are held on the first floor where private facilities are accommodated. These facilities are not accessible to residents. Ashwood unit has had two residents’ bedrooms fitted with ceiling mounted hoists. These are fitted in all areas other than the kitchen and dining room. Bedrooms were personalised to the occupant’s choice and contained personal items of equipment, family mementoes and pictures. The home was clean and free from odours. See recommendation 1. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 16 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36. Management, leadership, guidance and direction continue to improve so residents receive consistent quality care. A competent and appropriately trained staff team cares for residents. Staffing in the afternoons has increased so residents have access to improved staffing levels at all times. EVIDENCE: An improvement is the staffing establishment of the home has been made. One part time qualified nurse and four full time support workers have been employed. Due to this agency hours have reduced from one hundred and thirty three hours to forty-two hours a week. This number is expected to fall as recently appointed full time and bank staff receives Criminal Records Bureau clearance. Staffing numbers have been increased in the afternoons on both units to provide additional staff. Staff was very keen and enthusiastic about their relationships with residents and how residents rights were promoted. Staff said their experience was recognised and they were welcomed and supported by more experienced staff. They said they had received an induction into Ashwood and received appropriate training. A recently employed staff member said ’ I have been shown the fire procedure and fire exits. I have read residents’ essential life style plan and we were consulted about our views on his needs. I feel involved and staff treat residents as adults and equals. I honestly feel we treat residents as adults and respect them. A number of the experienced staff were very supportive to me. They answered any questions about residents, their needs or routines. I really enjoy working here. We have had training and watched the ‘No secrets video’ with one of the qualified staff. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 17 Tommy came and talked to us about the video and what we had learned and our views. I would challenge any person who I felt was giving poor practice. If I walked in on a staff member being abusive, I would remove the resident or the person doing the abuse. My first duty is to the resident and to protect them. We have received training on communication and challenging behaviour. Which was a two day course and dementia training another two day course. I would like to do my NVQ training. There is warmth to working here, everyone is approachable. I have worked on both units and enjoyed working on both of them. I am a co-worker to a resident and am pleased with this. I feel it’s a good thing, I am recognised for my contributions and input into the residents’ lives, a nice responsibility. We are involved in arranging social events for residents. I am arranging for a resident to go to a health spa. She has good family contacts. I went out to a concert with two residents the other day and they really enjoyed it ‘. Another staff member said /I wanted to put something back into the community and applied for this job. I have attended the induction programme, and had training on communication and challenging behaviour and Chris is fixing me up with a course on epilepsy as the resident I am a key worker to has this condition. I have had training on adult protection with Tommy. It was very interesting and made me aware. If I suspected abuse I would inform Tommy or one of the nurses. If I was not satisfied then social services. I have registered for my NVQ in my first supervision. I love working here; I get on well with the residents and staff. I have worked with most staff and they have all been brilliant a good team who give me advice and support. I can ask questions about residents and use my initiative. I have read residents’ care and essential lifestyles plans and contribute to writing care plans and at handover. I am a key worker to a resident. We enjoy going to the pub and visiting a friend at another care home. He likes to talk and read car magazines’. A recently appointed qualified staff said she found the staff team ‘supportive and very enthusiastic’. Another qualified staff member transferred from another care home. She said she enjoyed working in a staff team that was ‘ very generous in their interest in caring or residents. Staff are keen and enthusiastic and enthusiastic in promoting opportunities for residents. Staff are not just prepared to accept second best. The fundamental care is excellent, staff make sure resident have enough fluids, plenty to eat and look clean and presentable. There is a positive, inclusive culture of change’. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. The management routines and maintenance and testing of equipment needs to improve to safeguard the health and safety of people living in the home. Residents’ views and reviews underpin development in the home. EVIDENCE: Residents’ views and reviews have been incorporated into the development of Ashwood. A link corridor has commenced construction between the two units to allow safe access and egress between them. Staff training has been influenced by residents’ needs regarding their communication, health and mental health needs. Arrangements for three residents to live more independently are being made. The testing of the fire alarm system had improved and had been completed more regularly, but some weeks not tested as required. In a qualified staff meeting on 3rd November 2005 the minutes recorded that ‘it was the responsibility of the qualified nurses to test the fire alarms weekly’. The manager had commenced an audit of fire alarm testing and identified dates when the system was not tested. Due to an improvement in the testing of fire alarms the requirement has been amended to a recommendation. See recommendation 2. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 19 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 x x x x x Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X 2 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ashwood Nursing Home Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 x DS0000005144.V265266.R01.S.doc Version 5.0 Page 20 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. 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. 1 2 Refer to Standard YA28 YA42 Good Practice Recommendations Provide additional private visitng facilities for residents to use. The registered person should ensure that fire alarms are tested weekly as required. Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashwood Nursing Home DS0000005144.V265266.R01.S.doc Version 5.0 Page 22 - 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. 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