Care Home: Ashe Fields Residential Care Home

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What the care home does well The home has a detailed Statement of Purpose and all residents an relatives have access to this. All files examined held relevant information relating to residents and their needs, any limitations and their abilities. Formal reviews of care are held in consultation with the residents, relatives and other relevant professionals. All residents have access to a range of other professionals as necessary. Medication is administered appropriately and safely. Staff respect the privacy and dignity of the residents, knocking before entering bedrooms, listening to what the residents want and need. Relatives are able to visit the home without notice and are always made to feel welcome. The home has an activity coordinator who arranges a range ofactivities including arts and crafts. The home does try to meet and accommodate religious beliefs too. All staff have received training in Safeguarding Adults, Moving and Handling, First Aid and Fire Safety. The Manager stated that the company also provide training in a number of other areas in order to meet the changing needs of the residents. Staff receive regular supervision and annual appraisals this in turn helps to promote a good morale within the staff team. The home is well decorated and the furniture is of a good standard. Within the living areas there is plenty of seating for all the residents. There is a large conservatory overlooking well kept gardens. The Manager has made some positive changes within the home, these include building positive relations with staff and residents. The providers complete regular monitoring visits to the home. What has improved since the last inspection? The manager stated that she ensures adequate staffing levels at all times to meet the changing needs of the residents and additional training is provided to meet the changing needs.. Residents and relatives and supported to become more involved with the care planning. Meetings are held with the residents and their relatives. All rooms are being updated as necessary. CARE HOMES FOR OLDER PEOPLE Ashe Fields Residential Care Home Ash Lane Etwall Derby Derbyshire DE65 6HT Lead Inspector Vanessa Davies Unannounced Inspection 21st April 2008 09:30 21/04/08 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 Ashe Fields Residential Care Home DS0000069869.V362965.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. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashe Fields Residential Care Home Address Ash Lane Etwall Derby Derbyshire DE65 6HT 08715970786 01283 734674 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) Imperial Midlands Limited Miss Tiffany Collishaw Care Home 20 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (20) of places Ashe Fields Residential Care Home DS0000069869.V362965.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 - 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 - OP Dementia - DE The maximum number of service users who can be accommodated is: 20 17th April 2007 2. Date of last inspection Brief Description of the Service: Ashe Fields is a detached house in a rural setting approximately two miles from the village of Etwall. The care home provides social and personal care for up to 20 people aged 65 years and over, and also provides 2 day care places. All bedrooms are single rooms located on two floors, although none of the rooms have en-suite facilities. Access to the first floor is by stairs and a stair lift. The day areas include a large lounge, conservatory and dining room on the ground floor. Residents have access to well set out garden areas. The charges made for a room at Ashe Fields Care Home range from £353 to £450 per week. These charges are dependent on the needs of each person placed at the Home. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for the service is two star. This means the people who use the service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. In order to prepare for this visit we looked at all the information that we received and asked for, since the last key inspection on 10th April 2007. During the site visit case tracking was included as part of the methodology. This involved the sampling of a total of three people representing a cross section of the care needs of individuals within the home. Discussions were held with those people able to do so. Their care planning and associated care records were also examined and their private and communal facilities inspected. Discussions were also held with staff about the arrangements for their care and also for staffs’ recruitment, induction, deployment, training and supervision. Following discussions it was agreed that the people who live in this service would be referred to as ‘residents’ for the purpose of this report. What the service does well: The home has a detailed Statement of Purpose and all residents an relatives have access to this. All files examined held relevant information relating to residents and their needs, any limitations and their abilities. Formal reviews of care are held in consultation with the residents, relatives and other relevant professionals. All residents have access to a range of other professionals as necessary. Medication is administered appropriately and safely. Staff respect the privacy and dignity of the residents, knocking before entering bedrooms, listening to what the residents want and need. Relatives are able to visit the home without notice and are always made to feel welcome. The home has an activity coordinator who arranges a range of Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 6 activities including arts and crafts. The home does try to meet and accommodate religious beliefs too. All staff have received training in Safeguarding Adults, Moving and Handling, First Aid and Fire Safety. The Manager stated that the company also provide training in a number of other areas in order to meet the changing needs of the residents. Staff receive regular supervision and annual appraisals this in turn helps to promote a good morale within the staff team. The home is well decorated and the furniture is of a good standard. Within the living areas there is plenty of seating for all the residents. There is a large conservatory overlooking well kept gardens. The Manager has made some positive changes within the home, these include building positive relations with staff and residents. The providers complete regular monitoring visits to the home. 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. Ashe Fields Residential Care Home DS0000069869.V362965.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 Ashe Fields Residential Care Home DS0000069869.V362965.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 Quality in this outcome area is good. Detailed information available within the home and regular communications with residents ensures that changing needs of the residents are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a detailed Statement of Purpose for the home. Each of the residents has access to it. The records of three residents were examined during this visit, it was evident that residents are involved with the preparation of their care plans and information provided by the manager indicates that this is as a result of resident surveys and feedback received. When new residents are admitted to the home, the Manager is provided with a summary of the needs of each person, completed by the Social Services Dept Care Manager supporting each resident, copies of which were seen, the Manager also ensures that a detailed social history is documented to ensure that equality and diversity needs are met. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 9 Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 Quality in this outcome area is good. Detailed records, access to other professionals as necessary helps to ensure that residents needs are met and changes to needs are recorded and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the files examined contained details of the resident, their next of kin, their Doctor, the Care Manager from the Social Services Dept who assisted with the admission and the name of their key-worker in the home. The Manager has ensured that any possible limitations of choice, freedom and decision-making abilities, are recorded within the case file and reviewed at regular intervals. The senior staff of the home complete formal reviews and in addition, the keyworkers provided a written monthly update of the care needs and activities undertaken by each resident. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 11 Medication is administered by suitably qualified staff, the home keeps a record of medication received, administered and returned. Residents were asked if they could look after their own medication, “ oh no I don’t want to the staff do all of that” The information received from the Manager states that the staff are trained to treat each person as an individual and not put all the residents in the same group. The staff listen to what people have to say and take on board their wishes and beliefs. When a resident is in their room all staff are told to treat this as their own area, they knock before they enter the room and respect their privacy and this was evident during the visit. Residents spoken with said “staff are lovely nothing is to much”, when asked if the staff are easy to communicate with and do they listen, “staff listen to us and they are always around” Within the records examined were details of each resident’s choice of whether they wished to be buried or cremated following their death. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Quality in this outcome area is good. Regular communications with service users and their relatives ensures that choices and expectations continue to be met and therefore improve the lifestyle of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Relatives and friends of residents are able to visit at any time, and can be seen in private and this was evident on the day of the visit. Staff spoken with said that relatives could visit at anytime, one relative spoken with on the day of the visit said “we visit regularly and are always made to feel welcome, mum’s happy here and well cared for” The home now has an activities co-ordinator who organises events and trips. She also does arts and crafts on a twice-weekly basis, clients also play a variety of games, and do puzzles etc. The Manager said that active participation of residents in these activities has been very encouraging. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 13 The home has detailed records of likes and dislikes and what residents enjoyed doing prior to moving into the home, therefore assisting them to ensure the residents social life continues and where possible improves. The Manager stated that staff listen to residents enabling them to cater for their individual needs. Their individual needs are met by offering them a choice in what they wish to do within the realms of safety also ensuring that their beliefs can be accommodated by offering a wide choice not just tailored to one religion. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. Detailed Complaints and Safeguarding Adults procedures in place and suitable training for staff helps to ensure the safety of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One resident was asked if they were what they would do if they needed to complain, they said, “I’d tell the staff and they would deal with it.” The home has a detailed complaints procedure with a response time of 28 days from the initial complaint. The Manager confirmed that she does meet these timescales when any complaints are made, however there have been no complaints since the previous inspection. The Manager has a Safeguarding Adults procedure that includes a ‘Whistle Blowing’ policy. She also has a copy of the Public Interest Disclosure Act of 1998, and of the Dept of Health’s policy called ‘No Secrets’ available in the Home. She confirmed that all allegations and incidents of abuse would be promptly followed up and that all actions taken would be recorded. The policies and practices laid down by the Registered Providers ensured that all staff understood physical and verbal aggression by residents. The Manager also said that a policy was available to staff stating that they could not benefit from Residents wills. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 15 The Manager stated that all staff have completed Safeguarding Adults training and are aware of their role in the event of an allegation. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. A clean, tidy and well maintained home helps to ensure that people are safe and their visitors are welcomed into a pleasant homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour was made of the Home, which included some of the bedroom. The home is attractively decorated throughout, and the lounge and dining room are pleasant to sit in, and were provided with the appropriate items for the residents. There is also a large conservatory overlooking a very pleasant quiet garden. The bedrooms provided good space and provision for each person. The Registered Providers had provided appropriate furnishings in all locations seen Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 17 during the visit. The Manager stated that some rooms have had new carpets, and bedding. A new washing machine and drier has been installed, and a new dishwasher. There has been redecoration in some of the bedrooms and one room has been fully refurbished. Toilets were easily available to all and are clearly marked, and provided with handrails where necessary. A call system is available throughout the home. All bedroom doors are provided with locks, which residents could chose to use. The home had appropriate sluicing facilities, and laundry was washed at appropriate temperatures. There was no evidence of a malodour throughout the areas visited. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. Suitably qualified staff on duty at all times helps to ensure that people are cared for safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this visit it was found that more than 50 of care staff had a qualification of at least NVQ level 2 in Care, and therefore surpassed the expectation of the Commission. The manager stated that it is the companies aim to get all staff qualified to NVQ 2 qualification. The home has a rigorous recruitment procedure and all new staff have the relevant checks completed prior to any appointment. The home has a very low staff turnover and morale at the home is high. The Manager said that new staff would be provided with an induction and foundation training. She also said that all care staff were provided with at least three paid days training a year. All staff have regular 1:1 supervision with the Manager and annual appraisals. Ashe Fields Residential Care Home DS0000069869.V362965.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): 31,33,38 Quality in this outcome area is good. A suitably qualified Manager providing support to a stable staff team helps to ensure that people are safe and care is provided by a team who are keen to meet their changing needs and ensure their safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager is appropriately qualified to manage the home, having an NVQ level 4 qualification in Management and Care. The records of the monthly ‘inspections’ of the home, carried out by the Registered Providers, were examined and found to be in good order. The opinions of Residents families and friends or of GPs or District Nurses were not obtained on how well they thought the Home was achieving goals for Residents. Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 20 The Manager stated that the home does not hold any savings money for Residents. Residents purchases and hairdressing etc were paid by the Home and relatives were then billed for these amounts. Staff receive regular supervision and annual appraisals. Staff are provided with relevant compulsory training along with other training which may assist with meeting the needs of the residents. All residents have been risk assessed to determine their vulnerability and measures have been put into place to provide protection where necessary. The Manager was also able to show that all accidents, injuries and incidents of illness or communicable disease were recorded and reported to the relevant government bodies. Fire safety checks are completed as necessary and risk assessments are in place. Ashe Fields Residential Care Home DS0000069869.V362965.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 X 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 3 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 X X X 3 Ashe Fields Residential Care Home DS0000069869.V362965.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. Refer to Standard Good Practice Recommendations Ashe Fields Residential Care Home DS0000069869.V362965.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Ashe Fields Residential Care Home DS0000069869.V362965.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. Re-publishing this information is in breach of the terms of use of that website. 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