Care Home: Ashgrove Residential Home

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What the care home does well The home provides a good standard of care in a homely, clean, safe environment. Individuals are encouraged to personalise their rooms, helping them to feel settled and have a sense of belonging at the home. Staff are committed and caring and know people who live at the home well. This enables them to deliver personalised care and support. Meals are reported to be good with a good range of choices to meet individual requirements. What has improved since the last inspection? We did an annual service review on 20th April 2008. This did not involve a visit to the home but is a summary of new information given to us, or collected by us, since the last key inspection. The report is available at the home. The home strives to personalise care and act and listen to individual`s wishes. What the care home could do better: There were no requirements made at this inspection and two recommendations. The home recognises the areas they see as needing improving through information contained in the completed AQAA. CARE HOMES FOR OLDER PEOPLE Ashgrove Residential Home The Old Vicarage Church Lane St Martins Oswestry Shropshire SY11 3AP Lead Inspector Karen Powell Unannounced Inspection 21st January 2009 09:45 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 Ashgrove Residential Home DS0000020655.V373810.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. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashgrove Residential Home Address The Old Vicarage Church Lane St Martins Oswestry Shropshire SY11 3AP 01691 774101 NONE helenashgrove@aol.com 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) Mr Brian William Case Mrs Helen Case Mr Brian William Case Mrs Helen Case Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP) 10 The maximum number of service users who can be accommodated is: 10 23rd February 2007 Date of last inspection Brief Description of the Service: Ashgrove is a small privately owned residential home providing personal care for ten older people. The registered proprietors are Mr and Mrs B W Case who have been at the home since 1987 and live in the converted coach house on the same site. Ashgrove is partly an old vicarage and partly purpose built extension, located in the small village of St Martins, Nr Oswestry, accommodation is all on ground floor level for people living at the home, and is within easy reach of local resources. It is set out in its own grounds with pleasant gardens and a terrace for people who use the service to use. There is a large garden where home grown produce is cultivated. Visitors to the home are frequent. The home has good links with the local community. Fees are not contained in the service user guide as required. Readers wishing to know more about the fees should contact the home directly. Ashgrove Residential Home DS0000020655.V373810.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 this service is two stars. This means that people who use this service experience good quality outcomes. The inspection of the service was unannounced and took place on 21st January 2009 by one inspector over a period of three hours. A range of evidence was used to make judgements about this service to include discussions with people using the service the deputy manager, staff and a visitor. We also examined a number of records to include care records of people living at the home. Not all key standards were assessed on this occasion access to some of the records was not available due to the owners being off-duty at the time. Two people who live in the home were ‘case tracked this involves establishing individuals experience of living in the care home by meeting them, discussing their care with staff, looking at care files and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. Prior to the key inspection an Annual Quality Assurance Assessment (AQAA) document was posted to Ashgrove for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. The registered manager completed this and some comments have been included within this inspection report. The purpose of the inspection was to assess all 22 ‘Key’ National Minimum Standards for Care Homes for older people and any further standards necessary. Information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. What the service does well: Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 6 The home provides a good standard of care in a homely, clean, safe environment. Individuals are encouraged to personalise their rooms, helping them to feel settled and have a sense of belonging at the home. Staff are committed and caring and know people who live at the home well. This enables them to deliver personalised care and support. Meals are reported to be good with a good range of choices to meet individual requirements. 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. Ashgrove Residential Home DS0000020655.V373810.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 Ashgrove Residential Home DS0000020655.V373810.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): Quality in this outcome area is good. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a service user guide in place. This is a book about the home, which gives the reader information about what they can expect from Ashgrove if they choose to move in. We saw a copy of this, which was available in a vacant room where a new admission is expected to move into in the near future. Mr and Mrs Case encourage people to view the home before they move in. We looked at the assessments of two people who had recently moved to the home, Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 9 we saw that information had also been obtained from a healthcare professional involved with one of the individuals admitted. The home ensures that they carry out an assessment before agreeing to any admission, this is to make sure that the home can meet individuals needs. Ashgrove Residential Home DS0000020655.V373810.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): Quality in this outcome area is good. The health and personal care needs of the people living at the home are met ensuring their well being. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a plan of care, which contains basic details of how care staff should provide care and support for people living at the home. We spoke to people living at the home and in particular the two people we case tracked, individuals were very complimentary about the care they receive. People told us that the staff are kind and caring. One person told us I am so well looked after here, I feel like the Queen of Sheba. The people living at the home were well-dressed and looked well cared for. Daily records indicate that health care needs are monitored and where necessary health care support is sought. We saw records that a GP had been called when someone was unwell. We also saw records of an individual attending an outpatient department appointment. One person told us the home arranges for the optician to come Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 11 and see me. They continued to tell us that transport is arranged for hospital appointments and the chiropodist visits regularly. We saw staff speaking respectfully to people during the visit. People living at the home told us they are always treated with the utmost respect and that their dignity is maintained at all times. Discussion with staff and observations made during a visit demonstrated how well the staff know the needs of people they care and support. Medication administration, storage and receipts were generally satisfactory. The home has a robust receipt and disposal system in place. One medication administration record we checked did contain some gaps where medication had not been signed for. This was discussed with the deputy at the time of a visit. Controlled drugs storage does not meet current regulations and should be stored in a controlled drugs cabinet which complies to misuse of drugs (safe custody) regulations 1973 and amended in 2007. It was confirmed by the deputy and staff spoken to that only trained staff administer medication. Ashgrove Residential Home DS0000020655.V373810.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): Quality in this outcome area is good. The home provides a range of activities and have links with the local community, which means people can pursue their own chosen leisure activiti at the es. Meals are good and the menu offers a balanced, varied diet offering individuals choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People we spoke to told us they can rise and retire at times they prefer. Choices are given to people regarding their meals and individuals told us that staff know their likes and dislikes. Records of these were seen in personal care records along with records of nutritional monitoring where required. Everyone was complimentary about the food and people living at the home were seen to take their lunch in the dining room, a pleasant room where a social occasion is made of the occasion in a relaxed environment. One person told us we get a cake on our birthday and they make the day special for us. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 13 We saw snacks and drinks offered between meals, and fresh fruit was also offered during our visit. People we spoke to were happy with the level of activities provided by the home. One person we case tracked told us they like to take a daily walk. We saw them do this during our visit. Many people living at the home have the daily newspaper delivered. The hairdresser visits regularly and one person told us their hair care is looked after well by the hairdresser. A regular visit by the keep fit instructor provides weekly armchair sessions for those wishing to participate. People living at the home were observed to be relaxed in both lounges. One lounge was being used by people to watch the television and the other lounge was being used by people listening to music. The home has links with the local church and uses the bi monthly village magazine to communicate in. One individual who has recently moved in the home told us that the home is endeavouring to meet their religious needs, as this is important to them. People spoke about looking forward to the better weather and being able to utilise the patio area in the warmer months. Ashgrove Residential Home DS0000020655.V373810.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): Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and of their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy in place, which is available in the service user guide. People spoken to were very clear who they could make a complaint to. Because of the small size of this home the owners who play an active part in the day-to-day running of the service are available for people to approach. It was stated on the AQAA that the service has received no complaints since the last inspection. CSCI have not received any formal complaints. The home has policies in place for the protection of vulnerable adults. There have been no referrals to the safeguarding of adults process since the last inspection. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People stay in a well maintained home that is homely, clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and tidy and people we case tracked were happy to show us their individual rooms. Rooms were seen to be personalised and liked by the individuals concerned. Furnishings provided were comfortable and in keeping with the environment. The home is maintained to a good standard and has sufficient communal space for people to choose where they wish to sit. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 16 Laundry is carried out on the premises and everyone appeared to be wearing nicely laundered clothes. Staff were observed to be delivering clean laundry to individual rooms, and one person told us the linen is spotless. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People have safe and appropriate support as there are enough competent staff on duty at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA stated that there are ten permanent staff. It stated that three are qualified to NVQ 2 and three to NVQ 3. This exceeds national minimum standards which states 50 of staff should have this qualification. It was reported in the AQAA that the home intends to update the skills in first aid and food hygiene. Staff reported there are always sufficient staff numbers to meet the needs of the people living at the home. Staff turnover at the home is low and agency workers are not used to cover shifts if necessary. Clear lines of accountability are in place in the home and staff told us if they had any concerns they would report them straight to Mr or Mrs Case who are easily accessible to them. We were unable to assess the homes recruitment files but these were found to be satisfactory at the last inspection and will be inspected at our next Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 18 inspection. The AQAA stated that a robust recruitment process in place and that all pre employment checks are carried out before staff commence work. Ashgrove Residential Home DS0000020655.V373810.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): Quality in this outcome area is good. People have confidence in the care home because it is led and managed appropriately. The environment is safe for people and staff because appropriate health and safety practices are carried out. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was clear from discussions with individuals that Mr and Mrs Case are a well respected. It was also clear that people are happy with the care and support provided by the staff team at Ashgrove. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 20 It was observed that a comment box was available in the lounge, however people told us that they are in regular contact with the managers and deputy and feel comfortable directly discussing any issues they wish with the senior management team. One visitor spoken to said, the home is very good and if they had to choose a care home to live in Ashgrove would be the one. People living at the home told us its a family atmosphere. One person was able to compare their stay to somewhere else they had been. They said Ashgrove was home from home, there are no rules and people are free to go about their day as they choose. One persons daily record showed communication between a family and the home, and regular reviews also give people the opportunity to comment on their care and support. Mr and Mrs Case continue to keep up-to-date with good practice ideas produced in professional journals and belong to Shropshire partners in care. The service keeps records to show that people are kept safe, however these were not accessed on the day of the inspection but returned confirmation provided by Mr Case in the completed AQAA state all checks required under regulation are carried out as required. Ashgrove Residential Home DS0000020655.V373810.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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 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 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x x x 3 Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP9 Good Practice Recommendations There should be no gaps on MARs. A reason for medication not being given or other reason should be documented. This provides a clear audit trail. A controlled drugs cabinet should be in place. This is to comply with the secure storage of controlled drugs as specified in the Misuse of drugs (safe custody) regulations 1973 amended in 2007. Ashgrove Residential Home DS0000020655.V373810.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Ashgrove Residential Home DS0000020655.V373810.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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