Care Home: Ashlea Court Residential Home

Similar services:

• The Highlands
• Turret Villa Retirement Home
• Blenheim House
• 1 Lanark Close
• Mendip House
• Beaconsfield Court Care Home
• Ann Charlton Lodge

What the care home does well What has improved since the last inspection? The registered manager addressed all of the requirements of the last report with the exception of one that relates to the garden and is covered in more detail in the following section of this report. Refurbishment has been carried out in the home and every resident has received new wardrobes, drawers and a bedside cabinet. Both the ground floor and first floor corridors have been decorated and work has commenced on decorating the bedrooms. Written records that demonstrate how residents are cared for are improved and include a good range of information. Staff offers better support to those residents who require help when eating their meals by sitting with them. Each resident who requires assistance with mobility has had an assessment carried out by the occupational therapist. This has resulted in residents being provided with the correct aids and equipment and staff have received instruction on how to use them correctly. Despite the absence of an activities coordinator staff have ensured that residents have had a range of activities to take part in and this has included outings for a meal. Staff have continued to receive training relevant to their work and steps have been taken for some staff to receive NVQ training in housekeeping. CARE HOMES FOR OLDER PEOPLE Ashlea Court Residential Home Archer Road Farringdon Sunderland SR3 3DJ Lead Inspector Mr Clifford Renwick Key Unannounced Inspection 09:30 1st May 2008 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 Ashlea Court Residential Home DS0000034309.V356940.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. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashlea Court Residential Home Address Archer Road Farringdon Sunderland SR3 3DJ 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) 0191 5282526 0191 528 2532 Winnie Care Limited Ms Gillian Margaret Reed Care Home 40 Category(ies) of Dementia - over 65 years of age (22), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (28), Physical disability over 65 years of age (8), Sensory Impairment over 65 years of age (5) Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staff must receive suitable training regarding the needs of service users with early onset dementia within two weeks of the service user’s admission. 14th May 2007 Date of last inspection Brief Description of the Service: Ashlea Court is a care home, providing personal care for up to 40 older people, some of whom may have dementia related needs. Nursing care is not provided at the home, but District Nursing services can be arranged where necessary. It is a purpose built care home with accommodation provided over two floors, with level access throughout. Level access into the home is from the main car park to the front of the building. A lift provides access between the two floors of the home. There is a garden area in front of the home, which includes a paved seating area. The home is situated on the outskirts of Sunderland near to local public transport links. It is also situated near to a range of local facilities, including doctors surgery, shops, pubs and places of worship. The range of fees is £402.00 to £417.00 per week. Ashlea Court Residential Home DS0000034309.V356940.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 2 stars. This means that the people who use this service experience good quality outcomes. Before the visit: We looked at: • • • • • Information we have received since the last visits in May 2007. How the service dealt with any complaints & concerns since the last visit. Any changes to how the service is run. The provider’s view of how well they care for people. The provider in the annual quality assurance assessment (AQAA) submitted information to confirm what they are doing in the service. The Visit: An unannounced visit was made on the 1st May 2008. During the visit we: • • • • • • • • Talked with people who live in the home and also staff who were on duty. Held discussion with the Registered Manager. Observed staff working practices. Looked at information about the people who live in the home & how well their needs are met. Looked at other records, which must be kept in relation health and safety and staffing. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the home to make sure it was well maintained, safe and free of any hazards. Checked what improvements had been made since the last visit. We told the manager what we had found. The people who live in this home prefer to be known as residents therefore this term of reference is sued throughout the report. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 6 What the service does well: The residents benefit from a well designed home that offers level access on both floors, and equipment and adaptations are available to help physically disabled and frail people to get around the home. Each bedroom had its own en-suite toilets and hand washbasin. And residents have been encouraged to personalise their bedrooms with items of furniture and personal effect. Staff has a good rapport with residents and their visitors and this contributes to the welcoming atmosphere in the home. Discussion with staff and observations made confirmed that staff has a good understanding of residents needs, including those people with dementia. They deal with personal care tasks discretely and professionally and offer reassurance to those residents who at times become upset and unsettled. Attractively presented and nutritious meals are provided, which residents commented on in a complimentary manner. And acting upon comments made by residents in the residents meetings changes have been made to the menus. Residents and their relatives said many good things about this home. Their comments included: • • • • “The girls are great they do anything for you.” “I have no complaints and if I did I would tell the manager who would sort it out.” “They looked after my father really well and I do not know what I would have done without them.” “The food’s good.” Good training opportunities are in place for staff and the manager offers support to staff to ensure they follow consistent practices. What has improved since the last inspection? The registered manager addressed all of the requirements of the last report with the exception of one that relates to the garden and is covered in more detail in the following section of this report. Refurbishment has been carried out in the home and every resident has received new wardrobes, drawers and a bedside cabinet. Both the ground floor and first floor corridors have been decorated and work has commenced on decorating the bedrooms. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 7 Written records that demonstrate how residents are cared for are improved and include a good range of information. Staff offers better support to those residents who require help when eating their meals by sitting with them. Each resident who requires assistance with mobility has had an assessment carried out by the occupational therapist. This has resulted in residents being provided with the correct aids and equipment and staff have received instruction on how to use them correctly. Despite the absence of an activities coordinator staff have ensured that residents have had a range of activities to take part in and this has included outings for a meal. Staff have continued to receive training relevant to their work and steps have been taken for some staff to receive NVQ training in housekeeping. 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. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 8 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 Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 9 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&6 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service. No one is admitted to the home until a full assessment of needs has been carried out. This helps to ensure that prospective residents are offered the right type of care at the home. Intermediate care is not provided at Ashlea Court. EVIDENCE: The care file for the person most recently admitted to the home confirmed that a detailed assessment had been carried out by the social work that was arranging the placement in the home. The home ‘s manager and senior carers also complete assessments, relating to social interests, areas of risk, diet and special requirements they may have. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 10 Following this a plan of care has been developed. This details what actions the staff have to take to meet these needs. In addition to this the manager and staff also obtained detailed information from the resident and their family about the residents background, previous lifestyle and any interests the resident has. This assisted staff in building up a good social profile that is used to develop activities that residents like to take part in. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 11 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. We have made this judgment using a range of evidence, including a visit to this service. Each resident has a care plan that sets out how individual assessed needs are to be met by staff. And this ensures that staff follows consistent practices to meet residents needs. Resident’s health care needs are identified through assessment and observation, and areas such as pressure care and falls prevention is subject to adequate supervision and care practice. Medication is administered, recorded and audited in a way that follows recognised good practice. This contributes to resident’s general health and wellbeing. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 12 EVIDENCE: During this visit four residents care files were looked at to assess what written information was recorded. This process is known as case tracking and includes looking at all documented information in their care file, and all records that relate to residents health and welfare. Each resident has a written are plan and this offers advice as to how staff have to support residents. The file also confirmed how individual health needs are met and how good use is made of health professionals. Monthly reviews are also undertaken and these may result in the care plan being changed particularly if there are changes in residents needs. For one resident who present behaviours that challenge staff have introduced a recording chart to demonstrate how this is monitored and also what support is offered by staff. However as the charts had been photocopied they were difficult to read in detail and it was unclear as to what actions had been taken by staff. This was discussed with the manager who took immediate steps to rectify this and ensure that records were clear and readable. The manager has sought advice from the GP about how to best manage behaviours that challenge and this has ensured that staff follow best practice when working with residents. Risk assessments and manual assessments have been completed and these demonstrate how residents who have mobility needs are to be supported. The occupational therapist has worked with staff to complete individual assessments and this has resulted in specialist slings and lifting aids being provided. This ensures that residents are supported in a way that suits them whilst also ensuring their safety. The manager ensures that residents or their relatives sign the risk assessments agreeing with the way in which staff will support residents. And this has ensured that the residents and their relatives are involved in this aspect of the care provided in the home. Daily records are in place and these are used by staff on a daily basis to record how each resident spends their day. They also include any significant events that may have occurred and also whether a resident receives any visitors. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 13 Medication is handled and administered by senior care staff. And all staff has received certificated training in the safe handling of medicines. A monitored dosage system (Nomad) is used, whereby the dispensing pharmacist supplies each service users’ medication within a tray. This contains a series of small boxes that correspond to the four medication rounds of the day, and the seven days of the week. Printed ‘medication administration records’ are also supplied by the pharmacist. The registered manager has also introduced a recording system for staff to document the amount of variable dose and ‘as and when required’ medication administered. This can help ensure that accurate auditing can be undertaken. Two residents are supported by staff to administer their own medicines and appropriate systems are in place to monitor this. This practice is good and ensures that residents are able to maintain their independence whilst at the same time receiving support from staff to ensure that this is done safely. An audit was carried out for those medicines referred to as controlled drugs and this confirmed good arrangements are in place to deal with this. Observations made during the visit confirmed that staff administers medicines safely and in line with guidance issued by The Royal Pharmaceutical Society. Discussion held with residents and their families and observations made confirmed that staff treats them with respect. One relative who present during the visit had especially called into the home to thank them for the care they had provided to their father before he had recently died. They stated that while their father had lived in the home the staff had been “great” and “could not have done enough to make their father happy”. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 14 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. We have made this judgment using a range of evidence, including a visit to this service. Arrangements to provide activities and occupation have improved despite their being no activities coordinator. And a planned, activities programme organised by the staff is contributing to a more interesting and stimulating lifestyle for residents. The residents are supported maintain contact with family and other contacts should they wish. This can help ensure they do not become socially isolated. The residents are actively encouraged by staff to a good degree in exercising choice and control over their lives. This can help promote their independence. The residents receive a, varied and well presented, choice based, menu. This can help promote their general health and wellbeing. The support to people who need help to eat is adequate, but fails to uphold their dignity. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 15 EVIDENCE: There is currently no activities coordinator as they recently resigned due to ill health. In order to ensure that residents are able to take part in activities they like staff are organising this on a daily basis. The manager is in the process of recruiting a new person for the role of the activities coordinator. Discussions held with the residents confirmed that the activities in the home have improved and at present they can play dominoes, bingo, cards and take part in craft sessions. During the visit a musical sing along to songs from the war era was taking place on the upper floor. Observations made showed that most of the residents joined in. At the same time staff were playing a hoopla type game with some of the residents to provide stimulation. This raised a few laughs with the residents as they tried to throw the rings over the hoops. Records available in the home confirmed that residents had been involved in craft sessions some of which included making Easter bonnets and celebration cards. There have also been a number of day outings, which have included lunch in a pub, the Pullman Lodge which is an old train and a trip to the garden centre. The manager uses a local transport company who are able tom provide wheelchair accessible vehicles. This ensures that no one is restricted from going out regardless of his or her physical disability. In discussion with the residents they confirmed that they liked the trips out. The manager stated that now there were more men living in the home they had contributed to ideas as to where they should go for an outing, and this had also had a positive impact on the type of activities that the home had been asked to provide. Some of these activities had been film shows where staff had attempted to recreate the old cinema by showing classic films and having refreshments in the interval. And also bringing people in to show old historical films of the area. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 16 Activities sheets are in place to record what activities have been offered on a daily basis and whether people choose to take part. This provides good evidence to show what activities take place and when. There are no restrictions on visiting the home and throughout the visit there were a number of visitors. Some residents went out with their relatives and the staff supports this. In discussion with visitors they said that staff always make them welcome when they visit. They said, “the girls work hard” and always offer them refreshments. The manager and staff assist the residents to have choice and exercise control over their daily lives. A number of residents tend to follow their own routines and spend time in their bedrooms. The written care plans and assessments include details about resident’s lifestyles and also how they want to spend their day. The menus have recently been changed following discussion with residents at the residents meetings. And this has resulted in resident’s choices being incorporated so that they can have meals that they like. Lunch was taken on the first floor, which is occupied predominately residents who have dementia. As a result a number of residents required support from staff during the meal. For those residents who needed additional help to eat their meals this was provided by staff that sat with the resident and offered support in a discrete and professional manner. The meal was relaxed and unhurried and enabled the residents to spend time chatting both during and after the meal. The meal that was provided was hot and tasty and well presented and sufficient in quantity. In discussion with the residents they said they like the food and that there is always enough to eat. The tables in the dining room were nicely set with tablecloths and napkins and condiments were on the table. However the notice board that was used to display what meal is available is not placed in a position that everyone can see. In discussion with the residents they were not sure what was available until the meal arrived. As most of the people who use this dining room have dementia, there was little in way of visual aids such as menus to inform them about the food. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 17 Some items such as large bottles of concentrated juice were being stored on the floor inappropriately and a Hoover was being stored behind a door. This was discussed with the manager who was advised that items must be stored correctly in order to reduce the risk of someone falling over them. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 18 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 good. We have made this judgment using a range of evidence, including a visit to this service. A clear complaints procedure is available that is implemented to a good standard. This can allow residents, and their relatives, confidence in the process, and provide opportunity for the management team to improve the service provided. The manager and staff have a good understanding of local adult protection procedures. This can help contribute to the protection of residents from abuse. EVIDENCE: Since the last inspection there have been no complaints referred directly to CSCI to investigate. In discussion with residents and their families they confirmed that they have no complaints. Some relatives stated that if they had any concerns that they would discuss them immediately with the manager or staff knowing that it would be acted upon and to their satisfaction. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 19 The residents said that they do not have any worries but if they did they would tell staff. The home have a complaints procedure and this advises people on how to complain and to whom. This is prominently displayed in the entrance lobby. Robust procedures are in place to protect residents from potential abuse. The host local authority (Sunderland) publishes clear safeguarding adults (adult protection) procedures, of which the registered manager and staff are aware. And staff has received appropriate training in safeguarding adults, which was provided by the local authority. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 20 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, 21 & 26 Quality in this outcome area is adequate. We have made this judgment using a range of evidence, including a visit to this service. The home is clean, and well maintained. This can help promote a positive image for residents, and ensure they remain safe. External space poorly addresses the specific needs of people who live in the home particularly those residents with dementia. This means that ready access to external space and fresh air is limited. EVIDENCE: The interior of the building is in good decorative order and a number of areas have been refurbished as part of the ongoing maintenance programme. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 21 Communal lounges have comfortable seating, small tables, a television as well as a music system. The home was clean and tidy free of any unpleasant odours and there were no noticeable hazards at the time of the visit. The bathrooms on the first floor were being used inappropriately for the storage of a Hoover and clothing in linen baskets. This was discussed with the manager. The manager confirmed that residents do not use the bathrooms on the first floor as none of them offer assisted bathing. Residents who choose to have a bath rather than use the shower facility are supported by staff to use the assisted bath on the ground floor. A new assisted bath has been ordered and this will be fitted on the first floor to overcome the problem as described above. The home have the services of a maintenance man one day per week and this time is spent on dealing with everyday small repairs to keep the building in good order. As has been reported in the last two inspection reports the opportunity for persons with dementia to access the front garden areas is limited. A galvanized metal fence has been erected over some of the garden, blocking a walkway to an adjoining home and detracting from the ascetics and safety of the existing gardens. Guidance information was sent to the home’s manager regarding current good practice in the design of gardens for people with dementia. This sort of improvement has yet to be implemented in any way here. At the time of this visit the garden was not useable by any of the residents, as the grass needs cutting. The block-paved walkways are strewn with weeds and there are no seats. Discussion with the manager indicated that the hedges had been cut and steps would be taken to ensure the grass is cut. The manager confirmed that seats could be made available for residents to sit on which are plastic patio style chairs. However for some residents these would not offer safe and sturdy seating being light and easy to topple. The use of bench type seats would offer a more practical and safe solution to the seating problem. As there are no seats in the garden and the grass needs cutting none of the residents are inclined to use the garden area and the view from the windows is not inviting. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 22 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. We have made this judgment using a range of evidence, including a visit to this service. Staffing levels are sufficient to ensure that resident’s needs are met and staff receives sufficient training to support them in their work. Robust recruitment procedures are in place. This can help ensure that unsuitable candidates do not gain employment in the home. Good training opportunities are in place for staff and this can contribute to staffs’ understanding of residents needs and ensure sufficient competence to undertake their job. EVIDENCE: At the time of the visit there were sufficient staff on duty to ensure that residents were supported with their care. Staffing is divided between the two floors and work in two teams. Observations made confirmed that they were effectively able to meet resident’s needs throughout the day. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 23 As well as carrying out personal care tasks staff were also involved in providing activities. The home is currently without an activities coordinator so staff have organised a programme of events that they take responsibility for. Some staff have given up their own free time to accompany residents on outings and work is currently being carried out in preparing for the annual summer fete. As reported on the last visit an additional member of staff has been employed to work between the hours of 7am – 8am. This means that this member of staff can sit with residents once they arise from bed and offer the additional support they need. Since the last inspection eight people commenced work in the home though some of these eight people have left their employment. Staff recruitment practices are governed by a policy that aims to ensure equal opportunities practices are adhered to. Staffing files confirmed that all of the necessary information had been obtained when recruiting new staff. This includes an ‘enhanced’ Criminal Records Bureau disclosure prior to staff commencing duties. Protection of Vulnerable Adults List (POVA first) checks are also being received were necessary. Two references are always obtained prior to employment being offered. In addition to this staff sign a declaration confirming that they are physically and mentally fit for the post they have applied for. As previously stated in section 16 – 18 of this report staff undertake safeguarding adults training and four staff plus all of the newly employed staff underwent this training. Training in this area is ongoing and all staff undergoes refresher training as and when necessary. On the day of the visit staff that were not on duty came in for Food Hygiene training, which was being delivered by an external trainer. The training was being provided to all newly employed staff and those staff whose certificates had expired. Some staff are currently undertaking NVQ Level 2 training in domestic housekeeping. Providing this ensures that staff are kept up to date with best practice. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 24 Training records are available for examination and this confirms the staff training plan that was carried out during the last 12 months. It is also in the process of being updated to reflect training for the year 2008. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 25 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, 35, 36 & 38 Quality in this outcome area is good. We have made this judgment using a range of evidence, including a visit to this service. An experienced and qualified manager is in post and this ensures that the service is run in the best interests of the residents. Internal quality assurance systems have continued to be developed to an adequate level, but with scope for further improvement. This can allow the views of residents, relatives and others to be sought and the internal quality management of the service to be progressed. Residents personal monies are managed in a good way to ensure the interests are well served. Risks to the health and safety of residents, visitors and staff are minimised however bathrooms being used for storage could compromise this. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 26 EVIDENCE: The registered manager is experienced and holds the Registered Managers Award and also NVQ Level 4 in care. As part her professional development the manager has continued to undergo training that is relevant to her work. The manager has continued to operate a quality assurance file, which incorporates the views of service users and their relatives. Service users also have the opportunity to express their view at meetings, by questionnaire, and in day-to-day conversations with staff and the manager. It was confirmed by the manager that questionnaires are sent out yearly and views are sought about the services being offered. In looking at the questionnaires they operate on a scoring system and the questions are very broad. In their current format they do not offer the opportunity to gather sufficient information for example the questions are “ how satisfied are you with?” then you tick a score that you think is relevant. Discussion was held with the manager about how these could be improved with a view to obtaining more information from people. Including questions such as “what could we do better” and also offering the option of being able to remain anonymous when completing the questionnaire may assist in the quality assurance process. The manager on behalf of 20 residents holds monies. Records are in place that confirms that this is managed effectively and receipts are always obtained for any purchases made on behalf of a resident. Records are good, clear and allow any easy audit trail of all expenditure made. A process of formal supervision is in place and the manager has delegated some supervision responsibilities to the senior staff and cooks. The manager takes overall responsibility for supervising all senior staff. This has ensured that all staff has the opportunity to receive feedback on their work and also receive support with their ongoing training needs. Records of fire drills and fire instruction are maintained and these confirm that all staff receives the necessary instruction and training on how to deal with a fire/emergency. Accident records are maintained for residents and staff and these confirm that appropriate procedures are followed. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 27 The manager promotes health and safety in working practices and assessments have been carried out for the equipment that is in use. At times staff storing items in bathrooms compromises this and this was noted in section 19 – 26 of this report. And also by storing items on the floor and behind doors in the first floor dining room. This was discussed with the manager who took immediate steps to rectify this. In order to improve upon the safety of residents a secure door entry system is in use at the front door. This has assisted in being able to monitor who comes into the home and also minimise the risk of people with dementia or confusion being able to wander out of the home undetected. Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 28 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 2 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 3 3 X 3 Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? Yes 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. 1. Standard OP7 Regulation 15(2)(b and c) Requirement The registered manager must ensure that any records used for care planning up to date and legible. (Immediate) Timescale for action 01/05/08 2. OP20 23(2)(o) The registered manager must ensure that works are carried out to the gardens. So that all residents can safely and freely access the gardens and grounds. Bathrooms must not be used for storage, Any items that compromise the health and safety of residents and staff must be removed immediately. 31/08/08 3. OP38 13 (4) (b) 01/05/08 Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 30 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 Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Ashlea Court Residential Home DS0000034309.V356940.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!