Care Home: Ashbury

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What the care home does well People are assessed prior to admission Care needs are assessed, kept under review and met. There is an excellent varied range of activities in the home and people are given the opportunity to go on holiday. People mostly confirmed that they have a choice of good food. Complaints are listened to and acted on. Staff confirm that the home is a supportive place to work. Quality assurance measures are in place. The home is managed in an open positive and inclusive manner. What has improved since the last inspection? New dining room and sitting room chairs have been purchase. The sitting rooms and some bedrooms have been decorated. A domiciliary dentist and optician have been sourced. What the care home could do better: The service is operating well in all areas and has it`s own plans to continue with the decoration programme and to develop an area of the garden. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashbury 124-126 Aldwick Road Bognor Regis West Sussex PO21 2PA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Gawley     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ashbury 124-126 Aldwick Road Bognor Regis West Sussex PO21 2PA 01243824689 01243838225 ashtoncare432@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Susan Rosalind Newman care home 29 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 29 29 The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Ashbury is registered with the Commission for Social Care Inspection to provide personal care for up to 29 residents. The registration categories are; Mental Disorder, excluding learning disability or dementia-over 65 years of age (MD/E) Old age, not falling within any other category (OP) Learning disability over 65 years of age (LD/E) and Mental disorder, excluding learning disability or dementia (MD). Additional conditions of registration are; 1) No further service users in the OP category to be admitted, 2) A maximum of 5 service users in the LD/E category and 3) Only service users over 55 years in the MD category may be admitted. Care Homes for Older People Page 4 of 26 Brief description of the care home Ashbury is situated in Bognor Regis, West Sussex, close to the sea and the town centre, with gardens, local shops, and cafes nearby. All the bedrooms are single occupancy, with either bath or shower en-suites. Fee levels range between £400 and £735 per week. Additional charges are made for personal items such as toiletries, hairdressing and chiropody. The service is owned by Mrs. Susan Newman, and managed by Mrs. Margaret Hibbert. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This site visit as part of the inspection process was carried out on 15/04/09. It was undertaken by a lead inspector from the Commission for Social Care inspection. Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home and any documents required on the day were made available. We were in receipt of any seven surveys from people who use the service, which expressed great satisfaction with all aspects of the home. We received surveys from three staff and two professional. The professional surveys were very complimentary of the care offered in the home and the management of the home. People who use the service and staff were spoken to on the Care Homes for Older People Page 6 of 26 day and surveys undertaken by the home were available. People who use the service spoken to stated that they are happy in the home and that they enjoy the food. All appeared happy were well dressed and the atmosphere in the home was relaxed. There is an activities coordinator employed in the home and people expressed satisfaction with the activities on offer. Staff spoken to on the day stated that they were happy working in the home and that the management was supportive. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to admission. There is a good famiarization process to enable people to get to know the home and the area. Evidence: People who use the service are fully assessed prior to admission to the home. All medical and personal care need is assessed and recorded. This includes mental health, continence, mobility, and communication. Three people who use the service the service were case tracked and their pre admission assessment was present in the care plans. The AQAA stated that they continue to meet this standard on pre admission assessment. A prospective person wishing to use the service has been assessed and has visited the home. The registered manger was to meet her for tea in town today. Care Homes for Older People Page 10 of 26 Evidence: An up to date statement of purpose and service user guide is available. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All health personal and social care needs are met in a person centered way with the individuals choice being taken into account. This provides a safe and stimulating environment for people. Evidence: The AQAA stated that all needs are met and that independence is encouraged. All residents have a plan of care which is drawn up following full assessment. Three people who use the service were case tracked, Their care plans were inspected and these contained information on health, mental health, personal, and social need. There was evidence review and social services review, and daily records. Risk assessments are in place in relation to smoking, falls, mobility,nutrition, medication, using of of a key, moving and handling. Weight is recorded monthly and action is taken as indicated. A chiropodist visits six weekly. People are taken to the dentist in town if they wish. A Care Homes for Older People Page 12 of 26 Evidence: dentist and optician visits the homefor those unable to go out. Changes in continence needs are reported to the continence service. Professional visits such as those from the general practitioner (GP) and the community team in learning disability are recorded. The community nurses are consulted appropriately. Care is carried out in a person centered way and staff are asked to sign that they they have read the care plan and therefore are aware of the persons needs and preferences. Aids and equipment is available as assessed such as pressure relieving equipment and hoists. Medicines are received, administered, and returned correctly. Medicine administration charts (MAR) inspected were up to date. There are policies and procedures in place for the management of medicines. Controlled drugs were correctly recorded and were correct. The home does not have controlled drug cupboard and this will be a requirement of this inspection. People are able to self-medicate following risk assessment. Carers were observed offering care and assistance in a respectful and dignified manner. People who use the service spoken to all stated that care is offered as they wish. They fixed my medication for me when I came here They are very good here. There is real attention to social need and activities with a varied programme in place, many trips out and an opportunity to go on holiday. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide a programme of activities following consultation with and for the people who use the service. These activities and events matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Evidence: The AQAA states that people living in the home have choices in daily living and activities and that visitors are encouraged. There is an activities coordinator employed in the home and there is a very varied programme of activities. These include exercises, quizzes, cooking, painting and drawing. People who use the service had the opportunity to make Easter eggs last week. There is karaoke on Fridays. As well as the in house activities trips out are encouraged. People go to the shops, to the hairdresser out for walks, Courses are accessed at Chichester College for people. Two people spoken today had been out to the shops. People using the service can go out for coffee, evening meals out and some go to a disco monthly. There is a mini bus trip every Tuesday to places of interest in the region. There is a trip planned to go to a county Show. Holidays are arranged for small groups of people who use the service. There are seasonal events. People spoken to confirmed that they can be involved in Care Homes for Older People Page 14 of 26 Evidence: these activities and enjoy them very much. Those less able to go out are encouraged to join in as much as possible. A hairdresser visits the home for those people unable to go out. One professional survey received from a community psychiatic nurse commented Ashbury takes great care in optimising lifestyle choices for their residents whether it is attending Chichester College, taking someone shopping or to the pub People spoken to stated that they have choice in all aspects of daily life. Spiritual and religious needs are met. There is a two week menu in place offering choice. Most of the people spoken to today were very happy with the food, Food enjoyable, The food is good and there is choice. One person did say that there is not much choice at the evening meal but the cook and the registered manager stated that as far as possible they will accommodate all requests. The majority of the surveys received commented positively on the food, one commented The kitchen gives us comprehensive choice but another connented Too much tinned and easy food. There is a two week menu in place and this does show variety. The cook is newly appointed and will review menus. People who use the service who required help with their meal were assisted in an unobtrusive manner. The meal seen served today was appetizing, plentiful and nutritious. Frequent drinks were offered throughout the day. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service know that their complaints will be listened to, taken seriously and, where necessary, acted upon. People who use the service are protected from abuse. Evidence: There is a clear complaints procedure which is on display and which is included in the Statement of Purpose and Service User Guide. The procedure clearly identifies whom a complaint should be addressed to and the timescales in which a complaint will be dealt. It displays the Commissions contact details. People spoken to confirmed that concerns are listened to and any problems addressed. The registered manager is considering putting in place a complaints procedure in accessible language or pictorial format to ensure all people, with diverse needs, who use the service can understand it. People who use the service were clear as to whom they can raise concerns with. There are safeguarding policies and procedures in place. Staff have attended safeguarding training. Staff spoken to demonstrated an awareness of procedures to follow. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained environmentwith bedroomsdecorated according to their taste Evidence: The communal areas on this occasion were neat, clean, and free from offensive odours. The sitting and dining rooms are comfortable and are domestic in style with comfortable furnishings. There is new sitting and dining room furniture. One sitting room has a fish tank. There is new sitting and dining room furniture. The sitting room and some bedrooms have been decorated. People have been consulted on the decoration of their bedrooms. Bedrooms are clean, comfortable and personalized. There are appropriate toilet and bathing facilities for people who use the service. All bedrooms have en suite facilities and are personalized where possible. There are suitable hoists and call beel systems. Nursing beds are accessed vis the community nurses if a person is assessed as needing it. Mirrors are placed lower on the walls for those people who need this. Two bedrooms were malodorous due to continence problems and the cleaner already had the carpet cleaner out to deal with this. Care Homes for Older People Page 18 of 26 Evidence: There are pressure relieving equipment, hoists, wheelchairs and grab rails in place. There are suitable laundry facilities sited away from food preparation and storage. Machines have the necessary temperature programmes to deal with all laundry. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staffing levels to ensure residents needs are met by the numbers and skills mix of staff. People who use the service are supported and protected by the homes recruitment policy and practices. Evidence: On the day of the inspection the manager was on duty supported by a team of four care staff. In addition there were housekeeping and catering staff to ensure the premises are kept clean and residents are provided with cooked meals, snacks and drinks throughout the day. An activities coordinator is employed daily Monday to Friday. Staff rota showed sufficient care staff and ancillary staff to meet the needs of residents accommodated. People who use the service spoken to stated they were very happy with the care and activities provided. One survey received from a person who uses the service commented They are so good in so many ways. Another commented They are excellent There are robust recruitment procedures in place and staff files inspected (Emma Care Homes for Older People Page 20 of 26 Evidence: Brown and Veronica Hayden) contained documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history. Criminal Records Bureau Clearance and Protection of Vulnerable Adults (POVA) check, identity documentation, and photograph were all in place. One file had two references and the other had one reference. The registered manager is actively chasing the second reference for this person and the person only commenced after one reference, crb and POVA first had been received. Staff spoken to stated that this is a very supportive home to work in and they com firmed training and supervision. There is a staff training programme in place and staff files had evidence of training. There is induction in place and a workbook was seen. Ten carers have attained National Vocational Qualification (NVQ) Level 2 in care and one has NVQ Level 3.Two further carers are completing NVQ Level 3 Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being run and managed by a person who is fit to be in charge and is run in the best interests of the residents allowing people who use the service autonomy. Evidence: The registered manager has many years experience in care. She managed this home from 2004. She has completed the NVQ level 4 in care and The Registered managers Award. Quality assurance systems are in place and people who use the service, their families and health professionals are surveyed annually. The AQAA was completed and returned when we asked for it. People who use the service and staff spoken to all stated that the manager is very approachable and responds promptly to any requests. Two professional surveys received were very complimentary on the management of Care Homes for Older People Page 22 of 26 Evidence: the home, one commenting Ashbury is very fortunate in having Margaret Hibbert as manager Ashbury takes great care in optimizing lifestyle choices for their residents, the other commented that the service Allowed client autonomy, within a safe framework. one person spoken to stated that the home is well managed Margaret is on the ball One staff survey commented that I feel that this is a good care home to work in and the staff work as a great team. Staff meetings are held regularly but there have been some cancellations due to illness. Supervision is in place for staff and supervision records were seen. Staff spoken to confirmed that they receive supervision. The registered manager ensures that money for people who use the service is held securely and accurate records and receipts have been kept for money given to people or spent on their behalf. The registered manager ensures the health, safety and welfare of people who use the service and staff by the provision of mandatory training. Contracts are in place for equipment maintenance and utilities testing. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must supply a controlled drugs cupboard for the storage of controlled drugs, including Temazepam. This cupboard must comply with the Misuse of Drugs (Safe Custody) Regulations 1973 To store controlled drugs safely. 30/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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