Inspection on 18/06/07 for The Ashford Nursing Home

This inspection was carried out on 18th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Ashford Nursing Home 14/12/05

The Ashford Nursing Home 28/06/05

The Ashford Nursing Home 26/10/04

The Ashford Nursing Home 04/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Ashford Nursing Home 407 Hythe Road Willesborough Ashford Kent TN24 0JA Lead Inspector Lisbeth Scoones Key Unannounced Inspection 18 June 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Ashford Nursing Home DS0000026074.V327881.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. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 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 Ann Elizabeth Denne Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2005 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 residents 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 residents only. The Manager is an experienced first level nurse with a qualification in management. The home has been registered since October 1989. Weekly fees range from 438,81 for local authority funding and £833 (less free nursing care as assessed) for private fees. Additional charges include hairdressing £7 for a cut and dry, £21.50 for a perm and 12.50 for a cut and set. Chiropody fees are £8.50. Newspapers at cost price. The inspection report is available within the Information pack and on display in the entrance hall. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Monday 18th June 2007 between 10.00 and 16.00. It comprised discussions wit the manager, Mrs Ann Denne, all care staff on duty, a meeting with the majority of the residents and conversation with 6 residents. A tour of the building was made and records examined. The visit was further informed by an AQAA (Annual Quality and Audit) completed by the manager prior to the visit. Comment cards were handed out to ten residents and 10 relatives to obtain their view on the service. Some of these were returned and information thus obtained is incorporated in the report. A resident said,” I have been very happy here and made friends. Great staff.” A relative said, “The attitude of the staff is very good.” A thematic inspection visit took place on 20 December 2006, which “looked at the quality of information given to people about the care home and whether people experience open and fair conditions of care.“ What the service does well: What has improved since the last inspection? The manager reported that improvements have been made to care plans and communication with relatives. Door guards have been installed on all bedroom doors, which automatically close when the fire alarm sounds. New fencing surrounds the home. The laundry service has been improved. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Ashford Nursing Home DS0000026074.V327881.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 The Ashford Nursing Home DS0000026074.V327881.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, 2, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with information to make an informed choice of the services provided. However, the information needs to be updated. Every resident is provided with a written contract. However additional information should be written into contracts for self-funded residents. Residents are only admitted to the home following a comprehensive assessment. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home has an enquiry pack that includes the last newsletter, last inspection report and statement of purpose. However, the information therein was out of date and some information missing. Not included was a breakdown and range of fees for the home, details of “free” nursing care and the way this would be calculated and deducted from fees. Residents’ contracts are not routinely kept in the care home but at head office. On the day of the visit contracts could not be viewed. A requested sample was forwarded to the CSCI following the visit. At the inspection of 20.12.06, it was recommended that contracts for self- funding residents specify the room to be occupied and having been assessed as suitable to meet the person needs. The contract sampled at this inspection visit did not contain this information. The home must ensure that records specified in Schedule 4 are at all times available in the care home. The home undertakes a detailed, personal and comprehensive pre-admission assessment. The manager said that pre-admission forms have been improved. The Ashford Nursing Home DS0000026074.V327881.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, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear and consistent care planning system provides the staff with the information they need to deliver the care. Residents’ health care needs are met by a multidisciplinary team. Good medication systems and comprehensive arrangements are in place to ensure that the residents’ medication needs are met. Personal care is offered in a way, which protects residents’ privacy and dignity. Appropriately trained and supervised staff provide palliative care with sensitivity and respect. EVIDENCE: The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 11 A sample of care plans was examined and this had been well maintained and regularly reviewed. A series of risk assessments inform the care plan. Residents and their relatives are encouraged to be involved and contribute. Detailed daily records are maintained. A relative said, “They keep me updated as to when a GP has been called, or if medication has been prescribed due to a change in health.” Communication sheets to be used by relatives have been introduced in residents’ rooms. It is evident that other healthcare specialists are involved with residents’ care such as continence advisor, community psychiatric nurse, older people specialist nurse, dentist and hospice staff. Records of such visits are maintained. Risk assessments for the prevention of pressure ulcers are maintained. 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 manager has recently undertaken a palliative care course. Care staff are knowledgeable about the care of the dying and undertake regular training updates. The Ashford Nursing Home DS0000026074.V327881.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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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.V327881.R01.S.doc Version 5.2 Page 13 The home employs a welfare assistant who doubles up as a carer and hairdresser. Staff and residents’ relatives are involved with and invited to seasonal activities, which are organised regularly. An area to be developed is the attendance of events at the sister home by more able residents. The manager said that it is the homes’ intention to further increase activities for highly dependent residents. 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. A relative said,” The food is mostly home cooked using fresh ingredients. The style of food is very popular.” The Ashford Nursing Home DS0000026074.V327881.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: From information obtained from comment cards, it is evident that residents and relatives know who to talk to if they have a concern. The complaint procedure is included in the information pack and also on display in the home. Following the visit the CSCI’s address was updated. The complaint log contained one recent entry, which has since been resolved. The CSCI was made aware of a complaint made in March 2007. The complaint was investigated and found to be unsubstantiated. 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.V327881.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor within the home is good and well maintained. The home provides a safe, clean and hygienic environment EVIDENCE: The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 16 It is evident that the home is maintained to a high standard. A refurbishment and decorating programme is in place and ongoing. Residents’ rooms and communal areas visited are homely. The majority of the carpets have been replaced with laminate flooring. Over the next 12 months, the home plans to repair/replace existing windows frames and purchase new curtains and bedding. All shared rooms are currently used as single occupancy. Residents said and it was observed that the home is clean and free from unpleasant odours. Good infection control practices were observed and staff training provided. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 5 staff on duty in the morning and 4 in the afternoon. Staff turnover is low and agency staff are rarely used. 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 and 11 staff hold the qualification. A sample of staff files was examined and evidenced a good recruitment process. Following the inspection, such files are now securely stored at the care home instead of at head office. The induction programme meets the Skills for Care standard. Senior care staff are involved with induction training. The home employs 8 registered nurses. A system is in place that ensures that their NMC (Nurses and Midwifery Council) registration is current. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 18 A training officer has been appointed and training opportunities increased. A training matrix and individual training and development profiles are maintained. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 36, 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 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. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 20 EVIDENCE: Both the manager and her deputy have a management qualification. Roles and responsibilities are clearly defined and a management structure in place. The manager has an open door policy and easy management style. Staff said they feel supported by her. The provider supports the manager. The manager regularly works as the nurse in charge of a shift and has 12 hours supernumerary time. Quality assurance systems are being developed. Residents’ and relatives’ views are sought on a daily basis. Residents’ meetings are organised but poorly attended. Social events are organised to which relatives and staff get invited. Staff know residents’ likes, dislikes, hopes and aspirations very well. Formal Regulation 26 visits are carried out. At the previous visit the system for safekeeping and recording residents’ monies was satisfactory. There has been no change to the system. Staff confirmed that they have regular, formal and recorded supervision. Staff meetings are organised. Handovers at the beginning of each sift are an additional means of keeping staff informed. From information received prior to the visit, it is ascertained that all safety and equipment checks are regularly carried out. All staff have regular statutory training. Risk assessments are undertaken to provide a safe environment and to review safety measures and practices. Accident records are well maintained. The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 21 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 2 2 3 x x x 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.V327881.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes 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 OP1 Regulation 5 (1) (bb) (4) Requirement The registered person shall produce a written guide to the care home which shall include: (bb) Details of the total fee payable in respect of services referred to in sub paragraphs (b)&(ba) and the arrangements for the payment of such fees. In paragraph 1(bb) “total fee payable” means the fees payable before account is taken of any nursing contribution as defined in regulation 5a(6), which may be payable by a Primary Care Trust. In that: The enquiry pack (service user guide) has a clear breakdown of fees ranges charged per week and explanation of the assessment for Continuing care free nursing care with details of fees for each band. 2 OP2 17 (3) (b) Schedule The Ashford Nursing Home Timescale for action 31/07/07 The registered person shall ensure that records specified in Schedule 4 are at all times DS0000026074.V327881.R01.S.doc 15/07/07 Version 5.2 Page 23 4 available for inspection in the care home 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 OP2 OP16 Good Practice Recommendations That contracts for self-funding residents specify the room number and that the room has been assessed as meeting the residents’ care needs That the complaints procedure be updated in respect of the CSCI’s correct address and phone number The Ashford Nursing Home DS0000026074.V327881.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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