Care Home: Ashcroft House

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What the care home does well The home is well managed and the manager shows good leadership to the staff. She has a great rapport with people and a good knowledge of their individual needs. There is a warm and welcoming atmosphere in the home. Staff and people living in the home have good relationships and lots of positive interactions were noted. People who use the service said they were happy with their lifestyle at the home. They said they enjoy their independence and are able to please themselves in what they do. There is a varied and interesting activity programme which people are involved in. People spoke highly of the activities and comments included, "There is always plenty to do if you want to", "We have outside visitors who come along to get us involved in things" and "There is no pressure to attend if you don`t want to". The home has established close working relationships with other health-care professionals to make sure people`s health care needs are met and they have access to the full range of NHS services. Staff were thoughtful, discreet and respectful of people`s dignity when attending to any needs. It was clear that people who live at the home and the members of staff get on well. What has improved since the last inspection? This the first inspection since the home re-registration. What the care home could do better: A few care plans need some more detail in order that the information on how care needs are to be met is more clear. Nutritional assessments should be carried out on all people entering the home. The starting point should be people having their weight checked on admission to the home. Key inspection report Care homes for older people Name: Address: Ashcroft House 18 Leeds Road Bramhope Leeds W Yorkshire LS169BQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Frederick Rawlins     Date: 2 6 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 25 Information about the care home Name of care home: Address: Ashcroft House 18 Leeds Road Bramhope Leeds W Yorkshire LS169BQ 01132842822 01132842822 enquiries@ashcroft-house.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashcroft House Care Services Limited Name of registered manager (if applicable) Clare Louise Sutton Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category of service user 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 2. The maximum number of service users who can be accommodated is 32 Date of last inspection Brief description of the care home Ashcroft House offers accommodation of twenty-eight single bedrooms, twenty-two with en-suite facilities and two double bedrooms, one with en-suite facilities. The home is staffed to provide 24-hour care and attention, yet giving every encouragement for people to maintain as full and active lives as possible, with personal independence. All Care Homes for Older People Page 4 of 25 Over 65 32 0 Brief description of the care home service users are assessed prior to admission to ensure that their needs can be met. In the interests of other people using the service, Ashcroft House is a No Smoking Home. Fees cover the costs of full accommodation, care and laundry. Additional costs include the following chiropody, hairdressing, personal newspapers, and escort to hospital, incontinence aids and any other personal requirements. Several local doctors from Bramhope Medical Centre visit the home on request. People can choose their own doctor to visit if those individual practitioners are in agreement. The home has access to the following Health profesionals Occupational Therapist, Dentist, Optician, Physiotherapist and Chiropodist. At Ashcroft House they concentrate on traditional home cooking, with a varied menu to give a choice at all meal times. Meal times are as flexible as possible to meet peoples requirements. Care Homes for Older People Page 5 of 25 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: The inspection process included looking at information we have received about the service, as well as this unannounced visit to the home, which was carried out between 09:00 and 17:00 hrs. The purpose of the visit was to assess what progress the home had made and the impact of any changes in the quality of life experienced by people using the service. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An Annual Quality Assurance Assessment (AQAA) had been completed by the home before the visit to provide additional information. During the visit a number of documents were looked at and areas of the home were visited. A good proportion of time was spent talking with people who live at the home as well as their relatives and visitors.The manager and staff were also spoken with. Care Homes for Older People Page 6 of 25 Feedback was given to the manager at the end of the visit. The fees for the service currently range from 450 to 520 pounds per week. Details of the exact charge can be obtained by contacting the manager Care Homes for Older People Page 7 of 25 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 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 25 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 25 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. Peoples needs are properly assessed before admission, making sure their needs can be met. Evidence: From the discussions with the manager and checks made of four files it showed that pre admission assessments are made before people come to live at the home. Two of the files checked were for two people who have been recently admitted. Written information like the statement of purpose as well as discussions with staff and people living in the home showed that all people considering living at the home and their relatives are seen personally and a visit to the home is arranged when at least the relatives and if possible the prospective service user can see the room available and general facilities. Apart from the homes own assessment documentation, other information is gathered from any social worker or healthcare professionals that have been involved with the Care Homes for Older People Page 10 of 25 Evidence: person. The home has also introduced a life history form as part of the assessment process. This provides useful information about peoples lives, family, occupation, their preferred way of living including daily routines, hobbies and interests, personal care preferences, spiritual needs and food preferences. From all of the information collected, if the home believes it can meet the persons needs, a plan of care needed is written. Once living in the home, individuals progress is monitored to make sure that care needs are met. Care Homes for Older People Page 11 of 25 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. The care plans provide clear instructions for staff to follow making sure that health and personal needs are met. The people at the home are treated with respect and dignity. Evidence: People have care plans and risk assessments which have been developed from their pre-admission assessment information. The care plans focus on peoples strengths and abilities while providing information on what they need help with. The plans include life history work which makes them person centred and individual. The care plans also have details of any health professionals that people see. These include, GP, dentist, chiropodist, optician and the community health service. Records are kept of any health appointments and their outcome. A relative visiting the home Care Homes for Older People Page 12 of 25 Evidence: said They always respond well to medical needs and always keep you informed. During the focused observation, staff were seen helping people move safely. They were good at talking to people and helping them to feel safe. All of the people spoken with and their relatives said that they were happy with the care provided and relatives are kept informed and up to date with important issues. The medication records for the four people who were case tracked were checked and these were accurately kept. All drugs were noted to be stored properly and safely. It was clear from what people said that the staff are attentive and they live their lives in a dignified way according to their personal preferences. Observations during the day also showed that this was the case. Staff were good at picking up non verbal cues and made sure that all of the people got attention, support and assistance when they needed it. This applied to the more reserved people as well as more communicative people in the group. People said that they were treated like family members, and obviously felt respected and valued. Care Homes for Older People Page 13 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social expectations and personal preferences are met and they are able to exercise choice in their daily routines. People living at the home are provided with a varied and nutritious diet. Evidence: There is an activities programme that includes visiting musicians, crafts, poetry, reminiscence, gardening and various others, these are provided both by outside professionals as well as the homes own staff. Where possible people go out for walks to the local shops and a good number go out with relatives on a regular basis. In the conversations people clearly expressed that they follow their preferred ways of living; such as getting up times, going to bed, whether to spend time alone or with others, what activities to join in and what to wear. People looked well cared for and were happy with the arrangements for hair care and foot care. They said that if they need little things, such as pens or cards the staff go out and get this for them. The people living in the home talked positively about the food provided. The menus offer traditional English food and although they are asked regularly this is the Care Homes for Older People Page 14 of 25 Evidence: preferred option for all of the people spoken with. They said the meals are good, they have plenty and that they have a choice. The lunchtime meal was well presented and people said it was good. There was some quiet conversation between people and staff were good at encouraging and assisting people. One person said, As you can see the food is very good and theres plenty of it. Care Homes for Older People Page 15 of 25 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. There are adult protection procedures which staff have awareness of and understand and people can be assured that they can feel safe at the home. Evidence: The home has a clear complaints procedure that is explained in detail to people and their representatives upon admission to the home. A relative spoken with confirmed she had received a copy of the complaints procedure. All those spoken with said they knew how to complain. They were aware of the procedure and who to complain to. Many of them wanted to stress that they had no complaints though. It was clear from the conversations with people living in the home that they feel that all the staff are very approachable. People said that any requests were always listened to and they feel safe and well treated. Policies are in place aimed to set out how the home protects people using the service and prevents harm or abuse and this includes a whistle blowing policy. The manager was aware of the need to report any suspected or alleged abuse to the local authority and other relevant authorities. There have been no complaints from people living in the home or their relatives in the last 12 months. Care Homes for Older People Page 16 of 25 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. The environment is, in the main, homely, comfortable and safe for people who live at the home. Evidence: In the AQAA (Annual Quality Assurance Assessment) the Director said, We have undergone another year of comprehensive redecoration with a number of room being completely refurbished and a new hallway carpet laid. A new cooker has been purchased for the kitchen area. The outside patio space has been completely renovated and is now a much nicer area for people to relax outside. We have had a new fire alarm system fitted that displays exactly which detector has been activated greatly improving the safety of the home. A tour of the building was made. All communal areas were seen. These are comfortable and well decorated. People are encouraged to personalise their rooms and to bring familiar pieces of furniture in with them. They commented on how happy they were with their rooms, one said she had been able to bring her own things in with her. All the people living in the home and their relatives spoken with said they were happy Care Homes for Older People Page 17 of 25 Evidence: with the standards of cleanliness. Clinical waste is properly managed and staff wear protective clothing when attending to peoples personal care needs. Staff have received training in infection control. People spoke highly of the laundry service at the home. One person said, They do a real good job, things are nicely done. No obvious health and safety hazards were noted and the home was clean, tidy and free from unpleasant odours. Care Homes for Older People Page 18 of 25 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. People are protected by the homes recruitment procedures and staff are, in the main, trained and skilled to meet the needs of people at the home. Evidence: In the conversations with people living at the home they reinforced information that had been provided in the AQAA (Annual Quality Assurance Assessment) This is a healthy picture of a stable staff team that the people have got to know well and trust. They feel that they are treated like family. The rotas showed enough staff on duty to meet the needs of individuals and from observations made during the inspection it seems the dependency levels are low with most people being fairly independent. The staff know the individuals well and they are cared for in a consistent and personalised way. Recruitment is properly managed by the home; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to ensure staff are eligible for work. The personnel records for three staff members were looked at to make sure that the appropriate checks had been made and the other documentation that must be sought before someone starts work was completed. This proved to be the case. Care Homes for Older People Page 19 of 25 Evidence: The home makes sure that new staff follow the skills for care induction training programme. There was evidence of this in the staff records and also evidence of ongoing training to keep staff up to date with safe working practices. Over half of the care staff have completed their National Vocational Qualification (NVQ) level 2 in care. Other staff are also working towards this. Care Homes for Older People Page 20 of 25 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 well managed and the interest and health and safety of people at the home are, in the main, promoted and protected. Evidence: The management team consist of a registered manager, a deputy manager and a care supervisor, as well as a responsible individual (Director) who is at the home most days. The majority of the administration to do with the running of the business is carried out by the director. In the AQAA, the director said The manager is well respected and liked by staff and is highly competent in all areas of the day to day running of the care service. The home manager operates an open door policy and is always available to support and advise both people who use the service and staff. The home is managed in an open and transparent way and the home manager is committed to providing positive leadership within a relaxed atmosphere. Care Homes for Older People Page 21 of 25 Evidence: The information provided in the Annual Quality Assurance Assessment showed that safety checks are made of the facilities, equipment and services on a regular basis. The home provides a comprehensive manual of policies and procedures for staff to refer to. We looked at accident reporting and spoke to staff about this. Staff were clear on their responsibilities and how to report and record accidents or incidents. Staff meetings are being held frequency, regular individual supervision sessions are up and running and meetings for people living at the home are held on a regular basis. The staff and people living in the home all said without exception that the manager was approachable and listened to what was being said. The home carries out a satisfaction questionnaire survey and this helps ensure and monitor that standards at the home are maintained. Care Homes for Older People Page 22 of 25 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 23 of 25 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 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 1 2 7 8 A few care plans need some more detail in order that the information on how care needs are to be met is more clear. Nutritional assessments should be carried out on all people entering the home. The starting point should be people having their weight checked on admission to the home. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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