Care Home: Ashdown House

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What the care home does well The home provides good information for people considering moving into the home. People are visited prior to the person being admitted and when appropriate relatives are asked to assist in the process. Information gathered at this point assists in completing the care planning process. These documents are reviewed regularly, and ensure the best possible care is arranged for people. The home is safe with risk assessments on residents, their activities and regular safety checks being completed by staff and professionals employed from outside the home. Staff recruitment is another area where checks are undertaken prior to new staff coming in contact with residents. Medication is administered safely, and medical advice is sought appropriately when needed. Quality Assurance is widely practiced, with annual questionnaires being distributed widely to those with interests in the home. Complaints information is regularly updated with residents and their relatives, this prompts people if they wish to raise issues about the home. Comments received at the time of the visit indicated, " I enjoy it here, the staff are nice, and they get me the doctor if I don`t feel well". One person commented on - What the service does well, with; "meeting peoples needs and caring". A visiting professional indicated the home had "good staff". What has improved since the last inspection? The staff team have reviewed the care plans and risk assesments. The number of areas covered in the risk assesments have increased. Residents comments regarding less popular meal choices have been acted on and the menu changed accordingly. Some of the residents in a separate unit benefit from researched activities and pastimes. Some areas have been re-decorated. A new kitchen has been fitted, and the worn carpet in the lounge has been replaced. What the care home could do better: Records required after people move into the home, need to be completed on a regular basis. This to ensure staff have as full a picture as possible of peoples changing needs. Reciepts produced by the staff and other visiting people could be made clearer, and so make it easier to audit peoples monetery balances. Key inspection report Care homes for older people Name: Address: Ashdown House 13 Ashworth Street Daventry Northants NN11 4AR     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: Keith Williamson     Date: 1 5 0 5 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 23 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 23 Information about the care home Name of care home: Address: Ashdown House 13 Ashworth Street Daventry Northants NN11 4AR 01327879276 01327879276 ashdown.house@webandmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: S & P Group Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 24. The registered persons 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 are within the following category: . Old age, not falling within any other category - Code OP. Dementia - Code DE & DE(E). Date of last inspection Brief description of the care home Ashdown House is a care home for older persons, providing accommodation and personal care for up to twenty-four residents. The home is situated in the centre of Daventry and is close to shops, pubs and other local amenities. Accommodation is on two floors with the upper floor accessed by lift or stairs. There are four lounges and a dining room on the ground floor. The home offers both single and shared bedrooms some of which come with ensuite facilities. The home is situated in a residential street and has secluded gardens to the side and rear of the home and a small car park is available to visitors. Current charges range from £415.00 for a shared room per week Care Homes for Older People Page 4 of 23 24 0 Over 65 24 24 Brief description of the care home to £515.00 for a single room per week. Additional charges are in place if anyone wishes a double bedroom for single occupancy, and for hairdressing, chiropody, outings and personal items. Information about the home is provided in the form of a brochure. The Statement of Purpose document and the most recent CQC (Care Quality Commission, formerly known as the Commission for Social Care Inspection) inspection report are on display in the homes reception area. Residents and relatives are also advised that inspection reports can be accessed through the CQC website. Care Homes for Older People Page 5 of 23 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 focus of inspections is on outcomes for residents and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case two residents were chosen. This visit took place over one day, commencing at 9.30pm and took seven hours to complete. An opportunity was taken to talk with the residents, a relative, the manager and staff, look around the home, view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment, which gives information on the Service Users, home and the staff group. Comment cards were distributed to residents, their relatives and staff. Some of the comments have been included in this Care Homes for Older People Page 6 of 23 report. Three staff were spoken with, and all residents were seen, and their interactions with the staff group observed. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. Care Homes for Older People Page 7 of 23 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. Care Homes for Older People Page 8 of 23 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 9 of 23 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 10 of 23 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. Prospective residents receive information on, and have their needs assessed before moving into the home. Evidence: Prospective residents can expect to have their needs assessed before they move into the home this should ensure that staff have the experience and numbers to meet peoples needs. All the residents files were found to include an assessment of their needs, completed by a social worker or the senior staff member from the home. The home does not provide intermediate care. This is a special type of care offered to people being discharged from hospital, by a specialised team of staff. Care Homes for Older People Page 11 of 23 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. Residents are looked after well in a safe and secure environment, are treated with respect, dignity and their right to privacy is upheld. Evidence: Residents have care plans, which details the care they receive whilst in the home. This is important so people know how they will be looked after. These plans were up to date and had been reviewed regularly with the resident or a member of their family. Care plans are also risk assessed, which gives staff vital information how to keep people safe in the home. Again these risk assessments are reviewed periodically. From records kept by the home it was evident that health care services including General Practitioners and community nurses visit on the residents behalf. Staff working at the home are aware of the individual care needs of the residents, and those spoken with stated that peoples care needs were being met. Care Homes for Older People Page 12 of 23 Evidence: Medication is held securely and administered by senior staff in the home. Staff explained how the system worked showed an good knowledge of the detailed system. This is important as it increases the security for residents around medication administration. All residents and relatives spoken with felt that the care workers treated them with respect and throughout the visit care workers were seen interacting with the residents in a professional and dignified manner. Comments received at the time of the visit indicated, I enjoy it here, the staff are nice, and they get me the doctor if I dont feel well. One person commented on - What the service does well, with; meeting peoples needs and caring. Care Homes for Older People Page 13 of 23 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. People have a number of choices in the activities, social care and meals resulting in them being satisfied with the service offered. Evidence: Activities are organised in advance, some of these on an individual basis. On the day of the visit an outside entertainer was arranged to visit. The residents indicated he visited periodically, and were happy to join in the sing a long. There is some evidence of activities being completed with individual people and small groups, offering a more personalised service. People have a number of choices in the home, residents indicated flexibility in times of rising and going to bed, meals and activities. Meals are offered on an individual basis and staff are aware of peoples individual needs such as special diets, likes and dislikes. Care Homes for Older People Page 14 of 23 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. Staff ensure people are safe in the home, by the policies, procedures and regular contact with residents relatives. Evidence: Complaints are recorded appropriately, and investigated within set timescales. Complaint information is sent out to residents relatives, with the annual Quality Assurance questionnaires. This reminds people how to forward comments to the home or other agencies such as social services, and ensures people have the latest information to enable them to do so. There have been no complaints sent directly to the Care Quality Commission. There was evidence of postal voting slips available in the home, for the elections taking place that month. This demonstrates people are enabled to continue in the democratic voting process, even though less able to do this in person. Residents finances were checked but due to the complex nature of the purchase receipts, it was difficult to ascertain if the paper balance was correct. Receipts were not dated, nor kept in any order, thus making the accounting process more difficult. There has been one incident on alleged physical abuse, which is currently being investigated by the Local Authority. There were no other reported instances reported on to any other authority. Care Homes for Older People Page 15 of 23 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 standard of accommodation is good, providing residents with a comfortable and homely place to live. Evidence: Residents can enjoy this comfortable and relaxed home. Decoration is of a good standard and furnishings in the communal areas are domestic in character and in good condition. A selection of public rooms and bedrooms were seen during the visit. These were clean, appropriately furnished and included items personal to the people living there. Staff have received training in infection control and observations during the inspection confirmed that staff used appropriate protective clothing when carrying out their duties. There are two laundries in the home, both being well appointed and the floors and walls are easily cleaned. This is important as it helps guard against cross contamination within the home. Staff are aware of cross contamination issues, and have also had recent training. Care Homes for Older People Page 16 of 23 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. Residents safety is promoted by the recruitment process, and staff employed in sufficient numbers to meet peoples individual needs. Evidence: There were sufficient numbers of staff on duty in both areas of the home to meet the current needs of the residents. Residents and a relative spoken with felt that there were enough staff on duty to meet residents individual needs at all times. Residents are protected by a thorough recruitment procedure; this involves a detailed process prior to staff being appointed. Two staff files were checked, both were found to include all the necessary information including an application form, two references and Criminal Records Bureau checks. These are compulsory checks to enable the manager to ensure that staff have a fully checkable employment history, and are deemed suitable to work with vulnerable people. Training is recognised as important and courses are arranged with outside trainers as well as staff in the home. Staff training courses completed included; first aid, moving and handling, safe handling of medicines and food hygiene. These include courses for new staff and refresher courses for staff employed on a longer term basis. This is good as it shows staff knowledge is being continually updated. Care Homes for Older People Page 17 of 23 Evidence: A visiting professional indicated the home had good staff. Care Homes for Older People Page 18 of 23 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. Residents are protected by the management, staff, and detailed policies and procedures of the home. Evidence: The registered manager has experience in care, and has completed the NVQ level four and Registered Managers Award. The National Vocational Qualification is a nationally recognised course for staff in caring. Staff spoken with stated that they were well supported and positive relationships between residents; their relatives, management and staff were evident throughout the visit. Residents and staff are consulted with regard to how the home is run and meetings are held on a regular basis, to discuss how the homes future should progress. Quality assurance is performed throughout the year, and questionnaires are given to people in the home, and their relatives. The outcomes from the findings of the completed questionnaires are then given back to interested parties. This process has Care Homes for Older People Page 19 of 23 Evidence: yet to be completed this year. Residents finances that are held by the home are done so in a safe and efficient manner. Staff supervision which is where the staff are overseen on their ability to do tasks take place regularly. There is an individual training plan for each member of staff, this is put together following an assessment meeting. There is a programme of maintenance for the home, and tests are performed routinely by staff to ensure that people are safe. Care Homes for Older People Page 20 of 23 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 21 of 23 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 37 17 Records for the protection of 26/06/2009 people living in the home, must be kept up to date. This is to ensure accurate information is available on all people living in the home. 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 8 The monitoring of peoples health in line with the details in the plan of care would enable staff to monitor peoples health more closely. The record of medication disposed off, by the chemist could be duplicted. This would ensure a record was available for reference purposes. Information on medication that is carried forward from one medication month to another, could be copied into the new records. This would enable accurate mid month accounting of medication. To fully protect people from financial abuse a more coherent accounting system for residents monies is needed. 2 9 3 9 4 18 Care Homes for Older People Page 22 of 23 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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