Care Home: Ash Grove House

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What the care home does well One person said that they like living in the home and that they have "everything they need". Another said that the staff are "great" and "very caring" One visiting relative said that the accommodation is "very good", "is clean" and "well kept". They also said that staff are "very helpful and caring". There are enough trained and qualified staff available to meet peoples care needs in a relaxed and unhurried manner. Peoples care needs are identified to ensure that they get the care they need and to make sure they are safe. People or their relatives sign their plan of care and reviews to show that they have had a say and agree with the way care is provided. People are treated with dignity and their wishes are respected and acted upon.People can choose to take part in a range of organised activities if they want and can also choose their meals from a varied and balanced menu. The satisfaction surveys show that people living in the home and their relatives think the food is good. One visiting relative said, "The meals always look good" and "smell wonderful". People live in an environment that is well decorated, well maintained, homely, comfortable and safe. What has improved since the last inspection? To make sure that people living in the home receive the care and support they need everyone now has a plan of care that they or their relative agree and sign If there are any risks identified then risk assessments are now developed telling staff what they must do to minimise any risk to people living in the home and to those caring for them. To make sure peoples best interests are safeguarded, the medicines are now checked regularly and staff are trained in how to give medicines correctly and safely. To make sure people are safeguarded police checks are carried out on staff before they are employed, these records are now available and can be seen by us through the homes computers. The views of people living in the home and those of their relatives and other visitors on the quality of care provided is now sought through "satisfaction surveys". What the care home could do better: People living in the home were observed making decisions and making choices about how they live their daily lives. However, the daily records to not contain descriptive words to reflect and show peoples choices and preferences. The views of people living in the home and their relatives are sought through satisfaction surveys. However, there is not a report produced, and the finding made known to people, to show what people said or what action was taken by the home as a result of their comments. CARE HOMES FOR OLDER PEOPLE Ash Grove House Ash Grove South Elmsall Pontefract WF9 2TF Lead Inspector Tony Railton Key Unannounced Inspection 20th February 2008 08:00 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 Ash Grove House DS0000034486.V359006.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. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ash Grove House Address Ash Grove South Elmsall Pontefract WF9 2TF 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) 01977 723300 01977 723301 ashgrove@wakefield.gov.uk www.wakefield.gov.uk Wakefield MDC Mrs Irene McCombe Care Home 27 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (27) of places Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; Learning disability - Code LD - maximum number of places 1 The maximum number of service users who can be accommodated is: 27 26th October 2006 2. Date of last inspection Brief Description of the Service: Ash Grove House continues to provide personal care and support for up to 27 older people that includes permanent accommodation and places for those requiring short breaks. The home provides single bedrooms and there are a number of lounges, a large dining room and a recreational bar provided. The accommodation is on two floors and a passenger lift is provided, and assisted bathing if required. The home provides a designated area for people who chose to smoke. Some of the views from the upper rooms of the surrounding countryside are spectacular. There is a garden area surrounding the home and a secure courtyard with flowering shrubs and garden furniture to be enjoyed during the summer months. There is car parking to the front and side and the home is on a main bus route and close to local shops and public houses The manager said, on the 21st February 2008, that the fees for the service are £503.00 per week and there are extra charges for hairdressing and newspapers. Information about the home and the services provided and the role of the CSCI is available from the home or by e-mailing ashgrove@wakefield.gov.uk Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This service has been awarded a 2 Star rating which means that people using the service experience good quality outcomes. This visit to the home started at 08:00 and ended at 13:30. This was a very positive visit and a number of improvements have been noted. Throughout the visit there was the opportunity to speak to nearly all the people living in the home. Other people spoken to include, one visiting relative, the registered manager, the assistant managers, care staff, the cook, kitchen assistant and handyman. Six peoples records were seen and included, assessments, care plans, reviews, daily and medical records. Three peoples medicines were checked and three peoples finances were looked at. Six staff records were seen and included, recruitment checks, supervision records, appraisals and training records. Other information considered included the homes returned Annual Quality Assurance Assessment, containing information about the services provided, the Service History and the homes satisfaction surveys from people living in the home, their relatives and visiting healthcare professionals. The inspector would like to take the opportunity to thank the people living in the home for their warm welcome and hospitality throughout the visit, and the manager and the staff team for their patience and co-operation What the service does well: One person said that they like living in the home and that they have “everything they need”. Another said that the staff are “great” and “very caring” One visiting relative said that the accommodation is “very good”, “is clean” and “well kept”. They also said that staff are “very helpful and caring”. There are enough trained and qualified staff available to meet peoples care needs in a relaxed and unhurried manner. Peoples care needs are identified to ensure that they get the care they need and to make sure they are safe. People or their relatives sign their plan of care and reviews to show that they have had a say and agree with the way care is provided. People are treated with dignity and their wishes are respected and acted upon. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 6 People can choose to take part in a range of organised activities if they want and can also choose their meals from a varied and balanced menu. The satisfaction surveys show that people living in the home and their relatives think the food is good. One visiting relative said, “The meals always look good” and “smell wonderful”. People live in an environment that is well decorated, well maintained, homely, comfortable and safe. 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 summary of this inspection report can be made available in other formats on request. Ash Grove House DS0000034486.V359006.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 Ash Grove House DS0000034486.V359006.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): 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. Peoples care needs are assessed before they are offered a service to make sure the home can provide the care they want. EVIDENCE: Assessments seen showed that, to make sure their personal care needs are met, people are assessed before they come to live in the home. Six peoples’ people’s records, including their assessments, show that they have a say how they will be cared for and they sign their assessments to say that they agree with them. The assessments are available to the staff in the home on their computers and tell them how someone coming to live in the home should be cared for. The manager said that the home does not provide a specialist intermediate care or rehabilitation service. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. Peoples care needs are met and they are protected by the way medicines are dealt with. EVIDENCE: Peoples care needs are now set out in their individual plan of care. The six files seen show that people have a say in their assessments and are involved in reviewing their care plans as they sign them to show that they agree with what they say. There are now also risk assessments telling staff what they must do to minimise any risk to people living in the home and those caring for them. The daily records are good and show what people do. However, whilst people were observed throughout this visit having a say in what they do, the daily records do not contain descriptive words to reflect and show the choices they make or any decisions they take about how they live their day-to-day lives. The minutes taken when peoples care plans are reviewed show that people living in the home and their relatives and Social Workers are happy with the care provided by the home. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 10 The returned homes “satisfaction surveys” show that people living in the home and their relatives are happy with the care provided. One visiting relative said that they are “very happy with the care provided”. One person living in the home said that they have “everything they need”. Another said that they “like living in the home”. People are protected by the way medicines are dealt with as the medicines are checked regularly by staff and the pharmacist. The Pharmacist report shows that the medicines in the home are stored, recorded and given correctly. To make sure people remain safe, staff have had training in how to give people their medicines correctly and safely. The medicines of three people living in the home were checked and found to be appropriately stored, given correctly and properly recorded. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s lifestyle wishes are met and they have a say in how they live their lives and they are offered a varied and balanced diet. EVIDENCE: The cook said that all the meals provided are freshly cooked and that people can choose from the menu. The menu choice checklist showed that people are asked what they would like from the menu. People living in the home said that the meals are very good. One person said that the meals are “always good” and that they get “plenty to eat”. Another person said that they have a special gluten free diet and that the cook does very well in providing a varied diet for them to chose from. One visiting relative said that the meals always look nice and smell wonderful. People were observed enjoying their breakfast and lunchtime meals in a relaxed and unhurried manner in pleasant and quiet surroundings. The homes returned “satisfaction surveys” show that people living in the home and their relatives are happy with the meals provided. The minutes of the Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 12 residents meetings show that people have the opportunity to discuss the quality of the menu and the opportunity to change it if they want to. The manager said that there is a range of activities organised on a regular basis and the daily records and record of activities confirmed this. The daily records showed that people have enjoyed trips to the coast and to local garden centres. Records also show that some people had been to the theatre and others to local public houses and restaurants. The activities record however, does not show that everyone has been asked if they would like to take part in the activities that are organised. The assistant manager said that a record can be made of people that are asked if they would like to take part in activities. One person living in the home said that they enjoy doing arts and crafts and showed the inspector some Calendars they had made. People were observed throughout the visit being asked their opinion and having their choices and preferences respected. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 13 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 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s complaints are listened to and acted upon and they are protected from abuse. EVIDENCE: The manager said that the home has not received any complaints since the previous visit in 2006. This was confirmed by the homes service history and the returned Annual Quality Assurance document. To make sure people living in the home and visitors know how to make a complaint a copy of the complaints policy and procedure is now displayed. One visiting relative said that they know how to make a complaint but have never had to do this. Ten people living in the home, when asked about making a complaint, said that if they have a problem they usually tell the staff and they sort things out right away. One person said that they have lived in the home for a number of years and they have never had to complain about anything. People living in the home are protected from abuse, as the staff training records show that staff have had safeguarding training in how to protect people. The manager confirmed that all staff, with the exception of two new staff, have now had safeguarding training. Discussion with care staff found that Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 14 they have a good understanding of what abuse is and how to report any allegations of abuse. The homes returned “satisfaction surveys” show that people living in the home and their relatives and two District Nurses, when asked if they felt the home provided a safe environment, said yes. Ash Grove House DS0000034486.V359006.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 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a homely and comfortable environment that is safe and clean. EVIDENCE: A tour of the home found it to be well decorated, well maintained and clean. People were observed relaxing in the lounges, the dining room and their own bedrooms that are clean, homely and comfortable. One person said that they “love living in the home” and that they “have everything they need”. A visiting relative said that their relative’s room was nicely decorated, clean and homely. Two of the homes returned relatives “satisfaction surveys” say that the environment is excellent and that they are happy with the services provided. Fourteen returned residents “satisfaction surveys” show that people are very pleased with the way the home looks and say that it is clean, comfortable and homely. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 16 The maintenance records show that people living in the home where they are safe. Ash Grove House DS0000034486.V359006.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): 27,28,29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. The numbers and skill mix of staff meets people’s needs and they are protected by the way staff are selected and recruited. EVIDENCE: The manager said that there is always enough staff planned to be on duty to meet peoples care needs. This was confirmed by the duty rotas and through discussion with the assistant managers and care staff. Throughout the visit enough staff were observed to be available and to be meeting peoples care needs in a relaxed and unhurried manner. Discussion with people living in the home found that they like the people caring for them. One person said that the staff are “wonderful”, another said, “nothing is too much trouble”. A returned relatives “satisfaction survey” shows that they feel the staff are “very welcoming”, and “very sensitive” to residents personal care needs. A sample of the minutes of peoples reviews show that they and their relatives are happy with the care provided and feel that their care needs are met. Two returned “satisfaction surveys” from visiting district nurses show that they feel the home meets peoples personal and healthcare needs. Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 18 People living in the home are protected by the way staff are recruited and selected as a sample of six staff records seen show that they have references taken up and police and POVA (Protection of Vulnerable Adults List) checks before they are employed. This was also confirmed by the homes computer database that showed scanned copies of staff references and the dates of police and POVA checks. Peoples care needs are met by staff that are trained as staff training records show that nearly all staff have a National Vocational Qualification Level 2 or above. People living in the home are also in safe hands as the training records show that staff have First Aid, Moving and Handling, Health and Safety, Infection Control and Food Hygiene training. Ash Grove House DS0000034486.V359006.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): 31,33,35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a well managed home where they have a say in what happens and where their health, safety and welfare is promoted and protected. EVIDENCE: People living in the home were observed throughout the visit being asked their opinion and having their choices and wishes respected. The minutes of the residents and relatives meetings show that people have the opportunity to comment on the running of the home and on the quality of care provided. The assessments care plans and people and their relatives to show their involvement and to show that people have a say in what happens to them sign Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 20 reviews. The homes fourteen returned residents “satisfaction surveys show that people’s views are sought on the quality of care provided. The manager said that the view of the quality of care provided is also sought through “satisfaction surveys” from relatives and visiting healthcare professionals. The manager said that they have yet to provide a report to show what people said about the home and any action that they need to take because of people’s comments. The care management systems; including assessments, care plans and reviews, have improved and show that people and their relatives are involved in the planning and review of the care provided. The staff management systems have improved and show that people are safe and are protected by the way staff are selected and recruited and staff now have Safeguarding Training; although the two most recently recruited staff members have yet to receive this. A sample of three peoples monies were checked and found to be correct and show that their financial interests are safeguarded and protected. The health and safety and wellbeing of people living in the home is promoted and protected. As staff training records and maintenance records show that staff have the proper health and safety training and that the building is well maintained and safe. Ash Grove House DS0000034486.V359006.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 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 X 3 X 3 X X 3 Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 Refer to Standard OP7 Good Practice Recommendations The daily records would benefit from an increase in the use of descriptive words to reflect and show peoples choices and preferences. Descriptive words should be used in the daily records to reflect people choices regarding activities and to show any decisions they make about how they live their daily lives. The information gathered through satisfaction surveys should be collated and a report provided to reflect what people said about the quality of care provided and any changes to the way the home runs because of their comments, and this should be shared with people. 2 OP14 3 OP33 Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. Extracts may not be used or reproduced without the express permission of CSCI Ash Grove House DS0000034486.V359006.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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