Inspection on 28/06/05 for The Ashford Nursing Home

This inspection was carried out on 28th 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 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

The Ashford Nursing Home 18/06/07

The Ashford Nursing Home 14/12/05

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 Announced 28 June 2005 9:30 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 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 H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Ashford Nursing Home Address 407 Hythe Road, Willesborough, Ashford, Kent, TN24 0JA 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) 01233 645370 01233 645370 ashfordnursing@mail.com Opus Care Limited Mrs Claire Margaret Sherwood Care Home with nursing 22 Category(ies) of Older People x 19; Terminally Ill x 3 registration, with number of places The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26.10.04 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 H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 5 hours and comprised discussions wit the manager, deputy manager, three care assistants (two of whom senior) and 6 residents. A tour of the building was made and records examined. Prior to the inspection, 7 comment cards completed by residents’ relatives and one completed by a resident were returned to the CSCi. The general consensus of the comments was that the home provides a good service. 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 H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 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 standard(s) 1, 3, 5 1 The combined Statement of Purpose and Service User Guide provide residents and prospective residents with the information they need to make a decision about moving into the home. 3 Residents move into the home knowing that their needs can be met and their independence maximised and promoted. 5 An opportunity is provided to visit the home to get a feel of the quality, facilities and suitability. EVIDENCE: 1 The home produces an information pack (Service User Guide), which includes the statement of purpose. This provides useful information about the home including the complaints procedure and copy of the most recent inspection report. The home also produces a regular newsletter. 3 It is the home’s practice that every resident has a full assessment of need before a place is offered. The purpose of such an assessment is that the home ensures that it can meet the needs of the residents. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 8 5 It is the home’s policy to always provide prospective service users with the opportunity to visit the home and move in on a trial basis. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 9 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 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: The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 10 7 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 involved and contribute. Care plans are kept discreetly in residents’ rooms and detailed daily records maintained. In respect of daily records it was recommended that these include social activities residents have participated in. It was further recommended that entries as “no problems” are avoided. 8 It is evident that other healthcare specialists are involved with residents’ care as for example physiotherapist, continence advisor, the 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. 9 Medication administration records are well maintained. Good medication policies are in place including one for disposal of medicines. See also standard 26. 10 It was observed and confirmed by residents that staff treat them with kindness and respect. 11 The home is registered to care for residents with palliative care needs. Staff spoke 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 H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 15 12 15 Suitable activities and opportunities for social contact are provided. The meals in this home are good offering both choice and variety. EVIDENCE: 12 The home employs a welfare assistant who doubles up as a carer and hairdresser. A number of seasonal activities are organised regularly. Staff and service users’ relatives are involved with and invited to these. 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. 15 Residents praised the choice, variety and quality of the meals provided. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 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 standard(s) 16, 18 16 Residents know that their concerns and complaints are listened to and acted upon. 18 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. There have been no complaints made since the previous inspection. 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 H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 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 standard(s) 19, 26 19 26 The standard of décor within the home is good and well maintained. The home provides a safe, clean and hygienic environment EVIDENCE: 19 Residents said they like their rooms and the communal areas. Many of the carpets have recently been replaced with laminate flooring. One resident preferred carpet, which has recently been replaced. The carpet in one room is due for replacement and the maintenance person was in the process of completely redecorating a recently vacated shared room. 26 Residents said that the home is clean and free from unpleasant odours. Good clinical waste disposal systems are in place. The difficulties encountered in the safe disposal of medication were discussed in detail. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 27 Staff morale is high resulting in an enthusiastic well-trained and motivated workforce. 29 30 Recruitment policies are robust thus protecting the residents. staff are well trained and competent to do their job. EVIDENCE: 27 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. 29 A staff file examined confirmed that the home takes up references and carries out POVA and CRB checks in a timely manner. 30 Staff confirmed that training opportunities are good. A senior carer with an NVQ level 3 hopes to commence level 4 and has enrolled in a social care course. Senior care staff are involved with induction training. Palliative care course are provided for qualified and care staff. Four care staff are to attend a 5-week training course later in the year. Staff are to attend continence management and supervision and appraisal training. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 38 31 The home is well managed by an experienced committed manager who keeps herself and her staff informed of current practice. 33 Through effective quality assurance and quality mentoring systems, the manager ensures that the home is run in the best interest of the residents and their relatives. 36 Staff are well supported and supervised. 38 The health, safety and welfare of the residents and staff are safeguarded. EVIDENCE: 31 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. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 16 33 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. 36 The manager has delegated supervision duties to her deputy and senior care staff. All staff have regular formal supervision. Staff meetings are organised. 38 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 are well maintained. The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 4 x 3 The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 18 NA 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 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. Refer to Standard Good Practice Recommendations The Ashford Nursing Home H56-H05 S26074 Ashford Nursing Home V225871 280605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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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