Care Home: Ashingdon Hall Care Home

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What the care home does well Ashingdon Hall is well managed and run. People who live there are consulted regularly and their comments and suggestion are acted upon to improve their experience of living in the home. People who are looking for a home are given up to date and accurate information about the home, its location, staffing levels and qualifications and the services provided. Before a person is offered a place in the home the manager or other suitably skilled staff will carry out a detailed assessment of the person`s health, personal and social care needs and people are invited to visit to help them decide if the home will suit their needs. Staff are trained and supported to meet the assessed needs of residents. Each resident has a care plan based upon their needs as assessed before they move in. Care plans are reviewed and amended so that they are up to date. Risks to the health and safety of people living in the home are assessed, monitored and staff take action to minimise risks while helping people to live full and independent lives. Residents are well cared for and tell us that they are happy living in the home. Complaints and concerns are handled sensitively and investigated fully. Residents are encouraged to air their views and to make comments about the things they feel could be improved upon. The home is well maintained and kept in good order. The environment is clean and nicely furnished and residents can bring in items of furniture etc to help personalise their spaces. What has improved since the last inspection? This is the first inspection of this service. What the care home could do better: Information about the specific health and personal care needs of people living in the home could be written in a more person centred way so that it reflects each person`s wishes and capabilities. Staff must keep more accurate records for medicines in the home so as to minimise the risk of errors. All of the checks including references from each person`s previous employer must be carried out so as to help ensure that only suitable people are employed in the home. Key inspection report Care homes for older people Name: Address: Ashingdon Hall Care Home Ashingdon Hall Church Road Ashingdon Rochford Essex SS4 3HZ     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: Carolyn Delaney     Date: 1 7 0 5 2 0 1 0 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 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ashingdon Hall Care Home Ashingdon Hall Church Road Ashingdon Rochford Essex SS4 3HZ 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maureen Stewart Name of registered manager (if applicable) Mrs Anne Hicklin Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 17 The registered person may provide the following categories 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: Mental Disorder excluding learning disability or dementia (MD) Old Age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ashingdon Hall is a care home providing personal care and accommodation for up to a maximum of seventeen adults who may have a mental disorder. The home does not Care Homes for Older People Page 4 of 29 Over 65 0 17 17 0 Brief description of the care home provide accommodation for people who have been diagnosed with dementia. The home is a grade 2 listed building situated in the village of Ashingdon. There is a bus stop outside the home with links to Southend on Sea and Rayleigh. The home is situated close to Rochford train station with links to stations to London and Southend on Sea. Accommodation is provided in eleven single bedrooms and four double bedrooms (which may be used for couples who wish to move in together). The fees for a place in the home are £550.00 per week for a single bedroom, £600.00 per week for a single bedroom with ensuite facilities or a double room without ensuite and £700 per week for a double room with ensuite facilities. There is detailed information available on request about the services provided in the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the first inspection of the service since it was registered as a care home providing personal care and accommodation in November 2009. As part of the inspection we asked the manager to complete an Annual Quality Assurance Assessment. This is a document that providers of social care services are required under the Care Standards Act to send to us and tell us how they meet the needs of the people who use their services and how they evidence this. They also tell us how they plan to improve the services they provide. We review the information they give us and use this to plan our inspection. We sent surveys to people living in the home and staff who work there. We asked people to tell us about the service and to highlight any areas where the home did well and any areas where they felt improvements could be made. At the time of completing this report we had received surveys from seven residents and four members of staff. Care Homes for Older People Page 6 of 29 The information they provided was used in planning our inspection and the views expressed were used in helping us make judgements about the quality of services provided and the experiences of people who use the service. We reviewed other information available to us such as notifications of any illness, incidents or issues at the home which impact on the health, safety and wellbeing of people living in the home. We reviewed any information, complaints, concerns or allegations of poor practice or abuse we may have received about the service. We carried out a site visit to the home on 17th May 2010. We spoke with four residents, three members of staff, the homes manager and director. We looked at care plans and other written information that staff record about the needs of people living in the home and how they support them. We looked at the arrangements for ensuring that residents receive the care and medical attention they need, including medicines. We looked at how residents were supported in living their lives as independently as possible and the arrangements in place for providing opportunities for activities, socialising and occupation. We looked at how complaints and concerns were dealt with and how the views of residents were obtained and acted upon. We looked at the arrangements for recruiting and training staff and for safeguarding people who live in the home from harm and abuse. We looked at how the home was managed and maintained. Care Homes for Older People Page 7 of 29 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 Care Homes for Older People Page 8 of 29 order line 0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move into Ashingdon Hall know that it will be suitable for them because they receive detailed information about the service and their needs are assessed before they move in Evidence: The manager told us in the Annual Quality Assurance Assessment that they operate a strict pre- admissions procedure to ensure that they can meet the needs of people who move into the home. They told us that they arrange to see each person in their own setting to carry out a complete assessment of their needs, which will reflect their likes and dislikes to help to plan care and support for them. They told us that they offer each person and their families the the opportunity to visit the home prior to the individual moving in. They told us that residents tell them that they feel welcome as soon as they move into the home. Before we carried out our inspection visit we received completed surveys from seven Care Homes for Older People Page 11 of 29 Evidence: residents. Each of the seven told us that they had received enough information to help them decide if the home would be the right place for them. Four of the three told us that they had been given information about the homes terms and conditions (sometimes called a contract), the other three people told us that they did not know or could not remember. When we visited the home we looked at the information available about the home and the services offered. We looked at the homes brochure and service users guide. There was detailed information about the homes location and environment, including number of bedrooms, communal spaces and facilities for washing and bathing. There was information about the numbers of staff employed in the home, their roles, experience and qualifications. The service users guide described some aspects of daily life within the home and emphasised that residents were treated as individuals and encouraged to remain as independent as possible and to remain part of the local community. During the inspection we spoke with two residents who had recently moved into the home. They told us that they had met with a member of staff who spoke to them about the home and their needs before they moved in. Both people told us that they were happy living in the home. We looked at the arrangements for assessing the health, personal and social care needs of people before they were offered a place in the home. We looked at the assessments, which had been carried out for two people who had recently moved into the home. We saw that the manager or senior member of staff had visited both people and had assessed their individual needs. The assessment covered aspects of daily living including keeping safe, communication, personal care, social and behavioural needs, health and medical needs. Where specific areas for support were identified extra information was recorded around the persons preference for how they would like to be cared for. Following the assessment the manager made the decision as to whether the home would be able to meet their needs and whether to offer the person a place in the home. Prior to Ashingdon Hall being registered a care home in November 2009 it was registered and run as a domiciliary care agency providing care to people in a supported living environment. Following the change in service all people living in the home were provided with new contracts, which reflected the changes to the service they received. Each person was provided with the services of advocates to help them understand this process. Care Homes for Older People Page 12 of 29 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. People living in Ashingdon Hall are well cared for and supported for their health and personal care needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents tell them that they respond well to individuals needs and that they deliver tailored service that suits them. They told us that they carry out regular assessments and review plans on a continuous basis, which means that they can respond to to changes almost immediately they become apparent. They told us that they listen to residents preferences especially about who they would like their personal care delivered by, and whilst they cannot guarantee this will always be possible where they can they do. The manager told us that the general health of residents often improves after their admission to the home and that friends and families tell them that they see an amazing improvement after only a short while. They told us that residents tell them that they feel happy and well cared for. Care Homes for Older People Page 13 of 29 Evidence: Six of the seven residents who completed surveys told us that they always receive the care and medical support they need and one person said that they usually did. One person commented I get continued support and care in a thoughtful and kind way. Another person told us It is a happy place to live in. Three of the four members of staff who completed surveys told us that they always get enough information about the needs of the people they care for and one person said that they usually did. Two people said that the ways in which they share information about the needs of residents with other staff and managers always worked well and two people said that they usually did. When we visited the home we looked at the arrangements for supporting people living in the home for their health, personal and social care needs. We looked at the care plans, risk assessments and other records for three people living in the home. We saw that each person had a plan of care based upon the needs assessed before they moved into the home. Care plans described residents needs but were not written so that they reflected the person as an individual. Care plans did not include information around what residents could do for themselves or the level of support and care they needed. We discussed this with the manager who said that they would work on making written information about residents more personalised. We spoke with staff and residents and observed how staff supported residents. We saw that staff attended to residents needs appropriately and that they treated them well. Residents looked well cared for, clean and dressed in appropriate clothing, which they chose to wear. We looked at records around the health care needs of residents. We saw that when a person felt unwell that staff acted promptly in referring them to their doctor and acted on their advice and instructions. There were assessments completed to identify risks to the safety and welfare of residents. Risks around injuries from falls, going out alone, risks of developing pressure sores associated with poor mobility were assessed and recorded. At the time of the inspection no residents had pressure sores. We looked at the arrangements for ensuring that people living in the home received the medicines as prescribed for them. We saw that all staff who were responsible for handling and administering medicines were given training to ensure that they did so safely. We looked at the administration records for each of the ten people living in the home at the time of the inspection. We saw that records were generally well maintained and that staff signed records accordingly when they administered medicines. We had some discussion with staff and they told us that they order medicines two weeks in advance so as to ensure that they always had sufficient for the needs of residents. We saw that staff did not routinely check and record the numbers of tablets received into the home and this may increase the risk for error. We Care Homes for Older People Page 14 of 29 Evidence: discussed this with the manager and staff and they assured us that more stringent records would be maintained in the future. Care Homes for Older People Page 15 of 29 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 living in Ashingdon Hall can make decisions about their daily lives and are provided with appropriate opportunities to be part of their local community and to participate in recreational and social activities. Evidence: The manager told us in the Annual Quality Assurance Assessment that Ashingdon Hall is a very sociable place to live. They told us that relatives and friends of residents were welcome at any time and frequently enjoyed a meal in the dining room with the residents. They told us that there are three well furnished, comfortable lounges where visitors may be entertained. The manager said mealtimes and where to eat are flexible and meals may be taken in residents own rooms if individuals chose to do so. They said that there is always a choice of food at every mealtime and that food is of a high quality and home cooked using locally sourced fresh ingredients. The manager said that there are strong links with a number of local organisations with tea dances being organised by the local church group, quiz nights being managed by another and lunch outings being a regular and popular activity. They also said that the garden at Ashingdon Hall overlooks stunning views and this encourages picnics and parties in the garden in the summer. Care Homes for Older People Page 16 of 29 Evidence: Five of the seven residents who completed surveys told us that there were always activities planned in the home, which they could participate in and two people told us that there usually were. When we visited the home we looked at the arrangements for supporting people to live their daily lives in the way they chose and how they were enabled to remain active, occupied and to enjoy their social lives. We saw that residents were regularly asked about the things they would like to do. Regular trips to local pubs and restaurants for lunch were arranged, usually once a fortnight. Residents could go to local markets, South end on Sea, musicals and plays etc. Some residents were capable of going out alone to pursue social activities of their choice and we saw that residents were actively encouraged and supported to continue with past times and hobbies they enjoyed prior to moving into the home, such as gardening etc. On the day of the inspection some residents went out alone and one resident went out with the homes owner. Entertainment was provided for other residents. A local vicar visited the home and residents who chose participated in Tao Chi, which they told us they enjoyed. We saw that residents had been asked in regular meetings held about the things they would like to do in the forthcoming summer months and a day of croquet was planned when the weather improved. One resident we spoke with said We get taken out a lot. Another person said We go out for meals and I enjoy that. Five of the seven residents who completed surveys told us that they always enjoyed the meals in the home. One said that they usually did and one said they sometimes did. When we visited the home we looked at menus and the arrangements for providing nutritious and appetising meals for residents. We saw that there was a planned menu with home cooked food each day. There were alternatives to the planned menu such as salads, baked potatoes etc and residents were encouraged to ask for any particular food they liked. Residents particular likes and dislikes for food were recorded to help plan menus. On the day of the inspection we saw that residents were offered beef cobbler, vegetables and mashed potatoes. The meal was well presented and looked appetising. Staff take their lunchtime meal with residents and this helps to make a social and enjoyable event. We saw that residents were given ample time to eat in an ambient and unrushed way and staff offered extra portions to residents. Each of the four residents we spoke with during the inspection told us that they enjoyed the meals provided by the home. One person said The good here is very good. Another person said I always enjoy my meals and there is always plenty of good food. One person said Meals are good and always on time. I can help myself to tea and coffee anytime I want. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Ashingdon Hall know that their concerns will be taken seriously and they will be safeguarded from harm and abuse because staff are trained to recognise and deal with these issues. Evidence: The manager told us in the Annual Quality Assurance Assessment that all staff working in the home were trained to recognise and prevent abuse of vulnerable adults. They told us that staff understood the need to report any incidents they thought may be abusive. They told us that they had a robust safeguarding policy for staff to adhere to. The manager said that the homes recruitment policy and procedures helped to ensure that only the best staff were employed. The manager told us that they had a comprehensive complaints procedure, which was explained to residents and their families when a person moved into the home and copies were displayed throughout the home. They told us that staff had access to a Whistle Blowers policy, which helped assure staff that they could raise concerns without any fear of recriminations. Prior to our inspection visit we received completed surveys from seven residents. Each of the seven people told us that they knew who to speak with informally if they were not happy and five told us that they knew how to make a complaint. Each of the four members of staff who completed surveys told us that they knew what to do if anyone Care Homes for Older People Page 18 of 29 Evidence: raised concerned about the home. When we visited the home we spoke with four residents. Each of the four told us that they had no complaints about the home. One person said We can speak to the manager if we have anything to say. Another person said I am very happy and content here, I have no complaints whatsoever. We spoke with three members of staff and they told us that they had received training around safeguarding vulnerable people from abuse. One member of staff told us We listen to what residents want and if there is anything they are unhappy about and do our best to things right. Another member of staff said We always ask residents if there is anything we can do to make things better for them, I think everyone is happy here and well looked after. During the inspection we looked at the homes complaints policy and procedure. This clearly described how a person may raise concerns or make a complaint and how these would be dealt with. We looked at the homes complaints record and saw that one complaint had been received since the home opened in November 2009. We saw that appropriate action had been taken to address the concerns and the complainant had been reassured that they could raise any concerns without fear of recriminations. The complaint was fully investigated and resolved to the complainants satisfaction. We looked at the arrangements for safeguarding the welfare of people who live in the home. We saw that all but two newly recruited members of staff had undertaken training around safeguarding people who may be vulnerable. Both new staff had been given information around safeguarding including the homes policy and procedure and the local safeguarding teams policy and guidelines. Staff received regular supervision with the manager where work practices were discussed. We observed how staff engaged with residents throughout the day. Staff were respectful and treated residents well. We saw that there was an open and relaxed atmosphere in the home where residents felt comfortable able to speak freely with staff and the manager. We looked at how staff were recruited to work in the home. We saw that Criminal Records Bureau disclosures and Independent Safeguarding Authority checks were obtained for people before they commenced work in the home. These checks help to ensure that only suitable people are employed. Care Homes for Older People Page 19 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Ashingdon Hall are accommodated in a clean, safe and homely environment, which suits their assessed needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that they provided a safe, warm, comfortable and welcoming environment for residents. They told us that they ensured repairs and faults were dealt with quickly and by competent people and that detection and fire fighting equipment is regularly tested by a suitably qualified engineer. They said that the home was furnished with comfortable, appropriate furniture of a high standard and that bedrooms were also well furnished and residents were encouraged to bring in any item of furniture they wish to make their accommodation more personal. Bathrooms and toilets are well maintained and comfortable. Five of the seven residents who completed surveys told us that the home was always fresh and clean and two said that it usually was. When we viisted the home we looked at the environment. We saw that communal areas including lounges and bathrooms were clean and free from unpleasant odours and the home was nicely decorated and furnished. The home is a well maintained grade two listed building with may original features such as ceiling beams. Residents told us that they enjoyed living there. One person we spoke with said Its clean and homely here I like it. Care Homes for Older People Page 20 of 29 Evidence: Residents have access to attractive and well tended gardens and residents who choose to can plant flowers and shrubs. Care Homes for Older People Page 21 of 29 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 living in Ashingdon Hall are well cared for and supported by a dedicated staff team. Evidence: The manager told us in the Annual Quality Assurance Assessment that since opening they had increased staffing levels to meet the needs of people living in the home. They told us that they had a robust recruitment policy in place and that all staff working in the home were committed to providing personal and individual care to residents. The manager said that staff turnover was low and this helped create a strong team of individuals who worked together to promote the wellbeing of residents. Six of the seven residents who completed surveys told us that staff were always available when they needed them and the other person told us that they usually were. Three of the four members of staff who completed surveys told us that they felt there were always enough staff to meet the individual needs of residents and one person said there usually were. When we visited the home we looked at the arrangements for deploying staff to support residents. We looked at the staff rotas for four weeks. We saw that rotas clearly identified staff working in the home each day, their roles and designations. The rotas identified the person who was in charge of each shift. The manager told us that Care Homes for Older People Page 22 of 29 Evidence: the staffing levels for the current number of people living in the home (ten) was three during the morning, two in the afternoon and one person at night. They told us that these levels were reviewed regularly and that more staff would be employed if needed. We looked at rotas and these confirmed staffing levels. We also saw that staff had a minimum of one day off and usually two days off each week. Residents we spoke with during the inspection told us that staff treated them well and supported them as they needed. One person told us Staff are very friendly and helpful. Another person said They are always about to help me when I need it. Each of the four members of staff who completed surveys told us that all of the checks including references and Criminal Records Bureau disclosures were carried out before they started work. Three said that the induction covered everything they needed to know to do the job when they started and one said it partly did. When we visited the home we looked at the arrangements for recruiting staff to work in the home. We looked at the recruitment files for two people who had recently started work in the home. Criminal Records Bureau disclosures and Independent Safeguarding Authority checks (formally PoVA First) had been completed for both before they started work. These checks help to ensure that only suitable people are employed. We saw that both members of staff had been interviewed to further help determine their fitness. We saw that while references had been obtained for both, these had not been been obtained from their previous employers and full work histories with exploration of gaps in employment had not been obtained. We discussed these issues with the manager who assured us that improvements would be made to ensure that all checks would be carried out before staff were employed in the home. Each of the four members of staff who completed surveys told us that they were being given training, which was relevant to their roles, helped to keep them up to date with new ways of working and gave them enough knowledge about health care and medication. When we visited the home we looked at how staff were trained to meet the needs of residents. We saw that all but two new members of staff had undertaken training around safe moving and handling, safeguarding vulnerable people, mental health, fire safety and first aid. Staff had not received training around the specific needs of people living in the home such as epilepsy or diabetes and the manager said that this would be provided in the future. Care Homes for Older People Page 23 of 29 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. Ashingdon Hall is well managed and run in the interests of the people who live there because their views are obtained and acted upon where appropriate. Evidence: The manager told us in the Annual Quality Assurance Assessment that home is fully supported by the director of the business and that she was at the home most days and took a full and active role in the day to day life of the home. They told us that there is a fully qualified manager and a team of staff to carry out daily tasks, and an administrator to carry out other functions. They told us that the home was well run and that residents, their families and friends know that they can speak with the manager or director at any time they have concerns, comments or suggestions. Residents who completed surveys told us that they felt the home was well managed and that they were happy there.. One person said Ashingdon Hall is run very well. I like the way the home feels relaxed. Another person told us I have been here for two years and I have been really happy. I enjoy it here and I am much happier. One Care Homes for Older People Page 24 of 29 Evidence: person we spoke with during the inspection said This is an excellent home. Staff told us that they felt supported and that they met with the manager to discuss ways of working so as to improve the experiences for residents. When we visited the home we looked at the arrangements for managing the home and obtaining the views of the people who live there. We saw from staff rotas and discussions with staff and residents that the manager and director spent time in the home and that both had a hands on approach to the management and day to day running of the home. Staff told us that they felt supported and that they provided a good standard of care to residents. We saw that regular staff and residents meetings were held and records were kept about the things that were discussed at these times. We saw that residents were provided with the opportunity to express their opinions, make comments and suggestions about the things that were important to them such as meals, daily routines and social events and activities. After each meeting an action plan was developed so as to address the issues or wishes expressed by residents so as to improve the service and their experiences. We saw that staff and the manager met regularly to discuss ways of working, the staff team, the needs of residents etc. Any issues raised by residents were discussed and actions taken so as to make the necessary improvements. We saw that the home was managed in an open, relaxed and inclusive way where peoples views were sought and acted upon. The home had been opened since November 2009. At the time of the inspection the manager had not carried out a formal quality assurance procedure such as providing surveys to residents, their families and health and social care professionals to complete. However they told us that there were plans to introduce this in the near future. During the inspection we spoke with the manager about their experience and qualifications. They told us that they had over twenty years experience in social care and that they were currently undertaking their Leadership and Management Award (specific training for managers of social care services). Care Homes for Older People Page 25 of 29 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Staff must keep accurate records in respect of medicines received into the home. This must be done so as to minimise the risk of errors. 10/06/2010 2 29 19 All of the checks including 30/07/2010 references from each persons previous employers and checks on employment histories must be completed as part of a robust recruitment process. This must be done so as to ensure that only suitable people are employed in the home to meet the needs and safeguard the welfare of people living in the home. Care Homes for Older People Page 27 of 29 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 7 Care plans should be written in a more person centred way so that they reflect the individual needs of residents, their capabilities and he level of support they need. Care Homes for Older People Page 28 of 29 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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