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Inspection on 14/12/05 for The Ashford Nursing Home

Also see our care home review for The Ashford Nursing Home for more information

This inspection was carried out on 14th December 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a pleasant and well-maintained environment. At the time of the inspection Christmas decorations were contributing to a nice homely atmosphere. Staffing levels are stable and there has been little staff turnover. Staff interacted with the residents in a relaxed and respectful manner and they demonstrated a commitment to provide excellent care. They said they were well supported and supervised. Residents said they felt well cared for. They liked the staff and praised the food.

What has improved since the last inspection?

No requirement or recommendations were made at the previous inspection.

What the care home could do better:

This inspection did not identify any issues, which needed significant change.

CARE HOMES FOR OLDER PEOPLE The Ashford Nursing Home 407 Hythe Road Willesborough Ashford Kent TN24 0JA Lead Inspector Unannounced Inspection 14th December 2005 11.00 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 The Ashford Nursing Home DS0000026074.V265357.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 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. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Ashford Nursing Home Address 407 Hythe Road Willesborough Ashford Kent TN24 0JA 01233 645370 01233 645370 ashfordnursing@mail.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) Opus Care Limited Mrs Claire Margaret Sherwood Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (19), Terminally ill (3) of places The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Of the total number of 22 beds registered, service users 28th June 2005 2 beds are for residential Date of last inspection Brief Description of the Service: The Ashford Nursing Home is a two-storey extended building with a pleasant back garden providing seating facilities for its Service Users and their visitors. The home is situated in the centre of Ashford and the M20 motorway is nearby. There are 14 single rooms, two of which are en-suite and four double rooms, which have no en-suite facilities. Two of the single rooms are accessed by a step and can therefore be used by ambulant Service Users only. The Manager is joint owner of the home and is an experienced first level nurse with a qualification in management. The home provides care for two residents requiring personal care and 19 Service Users requiring nursing care including palliative care for up to three Service Users. The home has been registered since October 1989.The home is accredited to provide practice placements for two student nurses. The Ashford Nursing Home DS0000026074.V265357.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 3 hours and comprised discussions wit the manager, deputy manager, two care assistants, 6 residents and a visiting relative. A partial tour of the building was made and records examined. What the service does well: What has improved since the last inspection? 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 Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 6 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 The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 7 There is a clear and consistent care planning system, which provides the staff with the information they need to deliver the care. 8 Residents’ health care needs are met by a multidisciplinary team. 9 Good medication systems and comprehensive arrangements are in place to ensure that the residents’ medication needs are met. 10 Personal care is offered in a way, which protects residents’ privacy and dignity. 11 Appropriately trained and supervised staff provide palliative care with sensitivity and respect. EVIDENCE: A sample of care plans was examined and this had been well maintained and regularly reviewed. A series of risk assessments are used to inform the care plan. All senior staff, in their role as key worker, have responsibilities to keep care plans current. Residents and their relatives are encouraged to be The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 9 involved and contribute. Care plans are kept discreetly in residents’ rooms and detailed daily records maintained. It is evident that other healthcare specialists are involved with residents’ care as for example physiotherapist, continence advisor, community psychiatric nurse and hospice staff. Records of such visits are maintained. Records were seen of risk assessments for the prevention of pressure ulcers and appropriate pressure relieving equipment is provided for those residents deemed at risk. The manager regularly attends a Local Practice Development Group where health professionals discuss issues of best practice. All residents are registered with a GP. Hearing and sight tests as well as chiropody are facilitated. Medication administration records are well maintained. Good medication policies are in place including one for disposal of medicines. It was observed and confirmed by residents that staff treat them with kindness and respect. The home is registered to care for residents with palliative care needs. Staff spoken to said they are well trained in this specialist care. Care of the dying is part of the home’s induction programme and a number of staff have a recognised qualification (ENB) relating to this specialist care. The Manager and other staff undertake regular training updates as e.g. in the local hospice with which it has close links. See standard 30. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Suitable activities and opportunities for social and family contact are provided. Residents are enabled and encouraged to exercise choice and control over their lives. The meals in this home are good offering both choice and variety. EVIDENCE: The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 11 The home employs a welfare assistant who doubles up as a carer and hairdresser. Staff and service users’ relatives are involved with and invited to seasonal activities, which are organised regularly. A lunch at a local garden centre was planned and 14 residents would be attending. The home regularly produces a newsletter, which includes contributions from residents and details of activities provided and planned. Birthdays are celebrated with a cake. Photograph boards illustrate residents and staff’s enjoyment of the activities provided. Residents are enabled to attend church services and take part in events organised by the choral society. Residents said they enjoyed the food in respect of choice, variety and quality. Individual preferences are catered for. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Residents know that their concerns and complaints are listened to and acted upon. Staff have a good knowledge and understanding of adult protection issues, which protects residents from abuse. EVIDENCE: Residents spoken to said that they know who to talk to if they had a concern. The complaint procedure is included in the Service user Guide and also on display in the home. The complaint log contained one entry, which has since been resolved. Staff have a good awareness of those issues, which constitute abuse and would know what to do if this was ever witnessed or suspected. All staff have annual adult protection training. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The standard of décor within the home is good and well maintained. The home provides a safe, clean and hygienic environment EVIDENCE: It is evident that the home is maintained at a high standard. A shared room has recently been redecorated and refurbished. Residents’ rooms and communal areas visited were homely. The majority of the carpets have been replaced with laminate flooring. Residents said and it was observed that the home is clean and free from unpleasant odours. Good infection control practices were observed. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff morale is high resulting in an enthusiastic well-trained and motivated workforce. Recruitment policies are robust thus protecting the residents. Staff are well trained and competent to do their job. EVIDENCE: On the day of the inspection, there were 7 staff on duty in the morning and 4 in the afternoon. The home is recruiting for an additional member of staff for the 17.00 to 22.00 shifts. Staff plan their own duty rota and staffing levels are consistent and adequate to provide residents with the care they need. Staff confirmed that they enjoy the work and the training opportunities. NVQ training is encouraged. No staff files were examined as these are kept at head office. A recently appointed care worker confirmed that references were taken up and POVA and CRB checks made and that she had completed her induction training. Staff confirmed that training opportunities are good. Senior care staff are involved with induction training. Palliative care course are provided for qualified and care staff. Four care staff recently attended a 5-week training course. A staff member said how much she had enjoyed the course. Her The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 15 special area of interest was “mouth care”. Her colleague’s special project had been on “fatigue”. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 The home is well managed by an experienced committed manager who keeps herself and her staff informed of current practice. The manager ensures that the home is run in the best interest of the residents and their relatives. Residents’ financial interests are safeguarded. Staff are well supported and supervised. The health, safety and welfare of the residents and staff are safeguarded. EVIDENCE: Both the manager and her deputy have a management qualification and demonstrated that the home is well managed. Roles and responsibilities are clearly defined and a management structure in place. Recently, a Staff The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 17 Handbook has been complied. Policies and procedures are regularly reviewed and easily accessible. Though there are no formal quality assurance systems in place, it is evident that residents’ views are sought on a daily basis. Social events are organised to which relatives and staff get invited. Residents said that staff know their likes, dislikes, hopes and aspirations very well. The home looks after 1 resident’s personal allowance and the system for safekeeping and recording is satisfactory. The manager has delegated supervision duties to her deputy and senior care staff and in-house training for supervision and training is provided. All staff have regular formal supervision Staff meetings are organised. All staff have regular statutory training. Risk assessments are undertaken to provide a safe environment and to review safety measures and practices put in place. Accident records were not viewed at this inspection. The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 18 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 X x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 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 x x x x x x 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 3 3 x 3 3 x 3 The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 The Ashford Nursing Home DS0000026074.V265357.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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