Care Home: Ashlar House

What the care home does well The manager ensures that Ashlar House can meet the needs of prospective residents. People are given information and opportunity to visit the home as part of the decision as to whether it is the right place for the person to live. Care is provided in a person centered way and in an environment that is conducive to people living with dementia. This includes their personal, health and social care needs. People using the service/their representatives are satisfied with quality of the care provided at the home. Care management documentation is clear and detailed so providing staff with up to date information on how to meet each person`s needs and in the way they prefer and that keeps them safe. Medication is safely managed. Residents are treated with dignity and respect, supported to maintain skills and to make choices. They are cared for by a competent and stable staff team that can meet their needs and offer continuity of care. People feel confident to raise concerns and issues and that they will be listened to. Residents are safeguarded by the knowledge of the manager and staff and supporting systems and procedures. There is effective and supportive leaderhip and the service is well managed in the best interests of the people living there. What the care home could do better: No specific issues for improvement were noted in the areas inspected. The manager and staff team should continue with their planned developments as idenitifed in the manager`s AQAA. Random inspection report Care homes for older people Name: Address: Ashlar House St Margarets Hospital The Plain Epping Essex CM16 6TN two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Bernadette Little Date: 1 6 0 6 2 0 1 0 Information about the care home Name of care home: Address: Ashlar House St Margarets Hospital The Plain Epping Essex CM16 6TN 01992570691 01992570692 anne.driscoll@barchester.com www.barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anne Driscoll Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 36 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 36 The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Date of last inspection Brief description of the care home Ashlar House is a single storey, purpose built premises, located in the grounds of St Margarets Hospital. The premises include a number of sitting areas and a dining room with facilities to make hot drinks and snacks. The bedrooms are single with en-suite Care Homes for Older People Page 2 of 9 Brief description of the care home bathrooms. There are communal gardens that are enclosed and provide seating. The service has provision for 36 places for people with dementia. The service provides nursing care and has close links with the local Mental Health Trust. The service is registered to provide care to people aged over 65 years. It is on a main bus route and is a mile from rail and underground services. Epping is close to both the M11 and M25 motorways. Ashlar House is part of the Barchester Care. The manager advised that residents in Ashlar House are now funded from a variety of sources including different Social Services and Primary Care Trusts as well as through private arrangements. Information on current fees can be obtained directly from the manager. Care Homes for Older People Page 3 of 9 What we found: This was an unannounced random inspection. The visit took place over one day by one inspector and lasted a total of five hours. The purpose of the site visit was to monitor compliance to the Outcome Groups relating to Health and Personal Care, Complaints and Protection and Management and Administration. The manager was present and assisted throughout the site visit. As part of the process records relating to people who use the service, staff and the general running of the service were examined. We looked at all the information that we have received or asked for about the service since the last key inspection on 4th July 2007. This includes the most recent annual service review of March 2010. Prior to this inspection, we sent the manager a number of surveys to distribute to residents. We received seven completed surveys many of which indicated that relatives assisted the person with their completion. The manager submitted an Annual Quality Assurance Assessment (AQAA) prior to this inspection. This is a self assessment document, required by law, detailing what the service does well, what could be done better and how they plan to improve it. Information given in this document has been incorporated into this report. Discussion with the manager and detail in their AQAA confirmed that a comprehensive preadmission assessment is always undertaken before a service is offered and evidence of this was seen on files sampled. This allows the manager to be sure they meet the persons needs at Ashlar House and forms the basis for the persons plan of care. Surveys received from people using the service told us they received enough information to help them decide if this home was the right place for them before they moved in. People spoken with told us they had been welcome to visit the home unscheduled and on more than one occasion before making a decision about their relative going to live there. Two people said that they knew Ashlar House was the right place for their relatives as soon as they visited as they could tell by the atmosphere. Surveys received from residents/relatives told they always or usually receive the care they need at Ashlar House. This includes their healthcare needs. Visitors we spoke to during the site visit confirmed they always felt welcome at Ashlar House and spent a great deal of time there with their relatives. Visitors spoke highly of the care offered to the residents with comments such as excellent care, very happy with the care, the care is wonderful, much better than where (resident) was before and care is second to none. Relatives also told us that residents are cared for by regular staff which supports continuity and consistency of care, and that the nurses also get involved in hands-on caring for residents. They also told us that there are plenty of things going on for residents to be involved in and that the food is good and is provided very regularly to help people living with dementia to maintain good nutrition. Relatives also spoke highly of the staff and how they provide care to residents of Ashlar House with comments such as they work so hard, put so much in, helped (resident) to feel safe and always stay enthusiastic and positive and the staff spoil (resident) and all of them, they talk to them lovely and really look after them. Care Homes for Older People Page 4 of 9 Relatives also told us that people at Ashlar House are treated with dignity and respect for example staff speak to people well and use their names and always address people by name and work with the family to encourage (resident) with good personal care. Staff do talk to residents as real people. We observed that residents were offered active choices, for example from two plated meals at the time of eating, a choice of drinks, that tables were pleasantly set with cloths etc and that where staff provided support to residents this was undertaken in a sensitive and respectful way. Information from the manager confirmed that all staff receive training in dementia care, management of behaviour that challenges, and mandatory training such as infection-control, moving and handling, food safety and fire. The manager also told us that 19 of 26 care staff have achieved NVQ level II or above in health and social care and an additional five staff have commenced this training. Staff told us that there is good morale and a stable staff team who work well together. Medication recording and management was reviewed. A monitored dosage system is used. Records were maintained of medications received. The Medication Administration Record folder was well organised with a separate section for each resident with their name and photograph to support accurate identification. An overview of medication records in the file demonstrated no omissions, indicating that people receive the medication they are prescribed. Medications in the blister packs as well is those recorded in the controlled drugs register were sampled for some residents in line with their MAR sheets and were found to tally. A record was available of names of staff the manager has deemed competent to administer medication. Staff spoken with confirmed that they received medication training as part of induction and have assessments of their competence. We reviewed the management of complaints and safeguarding of vulnerable people at Ashlar House. The complaints procedure was displayed. Information received from people using the service/their relatives confirmed that they would know how to make a complaint and also that there is somebody they can talk to informally should they wish to do so to raise any concerns. People we spoke to told us that they feel listened to and responded to when they have raised small things. Comments included staff and manager are so friendly, you can go to them with anything, theyre like family and the manager is very approachable. Records demonstrate that staff have attended training in safeguarding vulnerable people. Discussions with staff demonstrated good knowledge of safeguarding vulnerable people and also in-depth understanding of how to link this in everyday practice with basic issues such as offering choice and ensuring dignity and respect is maintained. The manager has been registered with the Commission since the last inspection and is clearly experienced and competent in leading care for people living with dementia. Staff told us that the manager is supportive, recognises their input, is approachable and available and works with them on occasions providing hands on care to residents. Visitors also told us that the manager is approachable. The manager had met with fourteen relatives on a recent weekend to discuss for example the plan that staff will no longer wear uniforms to make the care experience more person centered and less institutional for people living there. The registered provider has an effective quality assurance system in place that includes gaining the views of relatives and professionals. The report of the most recent Care Homes for Older People Page 5 of 9 satisfaction survey was favourable in the overall opinion of the home. There are regular internal audits in place for example in relation to medication and health and safety. No health and safety hazards were identified at the site visit. The premises was clean, odour free, well maintained and provided a supportive environment for the residents. We reviewed a number of safety inspection certificates and all were found to be satisfactory. Current liability insurance was displayed. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 noncommercial 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. Care Homes for Older People Page 9 of 9 - 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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