Care Home: Ashleigh

Similar services:

• Snydale Care Home
• Abbey The
• Larchfield Manor
• Hawkhills
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well The people who live at the home told us they liked living there; one person said, "It`s like home from home". They told us that the food was good one person told us that "there is always plenty of it and there is always a choice at all meal times". They told us that they could come and go as they pleased one person told us that he regularly goes out and about on his own when he pleases. One person told us that she goes out with the help of staff or her relative takes her out. They told us that there were plenty of activities to choose from but they did not have to join in these if they didn`t want to. We saw that the home encourages people to be as independent as possible but there were always the right amount of staff on duty to help people and make sure they are cared for properly. We saw that the staff receive a lot of training about the need of older people and that they are trained in those areas which protect people from harm. We saw that the home makes sure that they haveall the information they need before some one comes to live at the home so they can meet their needs properly. What has improved since the last inspection? The home has re-carpeted the whole of the downstairs area. We saw that staff are now receiving regular fire training and that the home make sure the records they keep about the people at the home are updated regularly. CARE HOMES FOR OLDER PEOPLE Ashleigh 27 - 33 Ash Grove Beverley Road Hull East Yorkshire HU5 1LT Lead Inspector George Skinn Key Unannounced Inspection 20th May 2008 09:00 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 Ashleigh DS0000000834.V363197.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. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashleigh Address 27 - 33 Ash Grove Beverley Road Hull East Yorkshire HU5 1LT 01482 346959 F/P 01482 346959 iancrowther@hestoncourt.karoo.co.uk 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) Hestan Court Limited Mr Ian Crowther Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (37) of places Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; Dementia - Code DE(E) The maximum number of service users who can be accommodated is: 37 29th May 2007 2. Date of last inspection Brief Description of the Service: Ashleigh is a privately owned care home operated by Hestan Court Ltd and managed by Mr Ian Crowther, one of the company directors. Ashleigh is registered to provide care for up to 37 older people who may also suffer from dementia. The home has two floors with the first floor being accessible by a chair lift and a passenger lift. Two areas of the first floor are not accessible by either of these as they are situated on a different level and bedrooms therefore are only occupied by people who are ambulant. The home has 19 single and 9 double bedrooms, of which three offer en suite accommodation. Space available for the use of all the peole who live at the home includes a lounge, quiet lounge, smoking lounge and dining area. There is a garden/patio area to the rear of the home. The home is on a street, which runs off the busy Beverley Road, with easy access to local bus services. Shops, churches and public houses are all near to the home. Fees charged currently by the home range from £305.50 to £348.50 with a £12 top up fee. Additional costs for hairdressing, chiropody, optical, dental all of which are invoiced directly to the person. People who live at the home, or their families, provide toiletries. Ashleigh DS0000000834.V363197.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 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 5 hours. We spoke with the people who live at the home, their relatives and staff. Records relating to the people who live at the home, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The Manager was available to assist throughout the day. What the service does well: The people who live at the home told us they liked living there; one person said, “It’s like home from home”. They told us that the food was good one person told us that “there is always plenty of it and there is always a choice at all meal times”. They told us that they could come and go as they pleased one person told us that he regularly goes out and about on his own when he pleases. One person told us that she goes out with the help of staff or her relative takes her out. They told us that there were plenty of activities to choose from but they did not have to join in these if they didn’t want to. We saw that the home encourages people to be as independent as possible but there were always the right amount of staff on duty to help people and make sure they are cared for properly. We saw that the staff receive a lot of training about the need of older people and that they are trained in those areas which protect people from harm. We saw that the home makes sure that they have Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 6 all the information they need before some one comes to live at the home so they can meet their needs properly. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who live at the home experience good quality standard in this area. This judgement has been made using available evidence including a visit to this service. 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, what they hope for and want to achieve, and the support they need. EVIDENCE: We looked at the files which belong to the people who live at the home and these contained evidence of a full needs assessment being made prior to them moving in by both the home and the placing authority. We saw that the assessments involved all relevant parties including the person or their relatives. The home then develops a care plan from their own assessment and the local authority’s assessment. The home sends written confirmation to the person who is moving in, or their relative, that they can meet their needs. The home does not admit people for intermediate care. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 9 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 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. EVIDENCE: We looked at four care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan; these contained risk assessments around the area of falls, tissue viability, nutrition and diet. At the last inspection it was noted that some of the care plans had not been updated for some time. We saw that all of the care plans we looked at during this site visit had been updated regularly and changed along with the changing needs of the person. The daily notes were comprehensive and reflected how the home met the needs of the people who live there. Risk assessments were in place for those people who had bedrails Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 10 fitted to their beds to ensure their safety; we saw that these were in line with current guidelines and recommendations issued by the Department of Health. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses (CPN). Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. Occupational therapist, optical, dental and chiropody services are arranged privately and paid directly by the people who live at the home or their representative. When we spoke with the staff they were clear about how to maintain someone’s dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured in a separate room. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. The home have changed the pharmacist who supplies the medication since the last inspection and they are happy with the service provided. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 11 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 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can take part in activities that are appropriate to their age and culture and 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. People are helped to be as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, wellpresented meals and snacks, at a time and place to suit them. EVIDENCE: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. We saw that a selection of activities are arranged for the people who live at the home to take part in if they wish; these included reminiscence, one to one discussions, bingo, quizzes, table games, dominoes and crosswords. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 12 Advertisements around the home told us that that entertainers visit regularly and during the summer months taxis are booked for trips out, weather permitting. We saw that representatives of the local Anglican Church visit regularly and chat with people who live at the home; they can also visit the church if they wish. A service is held in the home at Christmas and Easter. Visitors are welcome at any reasonable time and one relative visiting at the time of the site visit said “the staff are very good and caring and I’m always made welcome”. When we spoke with the people who live at the home about the food they told us it was very good. One person said “there is always plenty of it and there is always a choice”. The cook visits all the people who live at the home every day to establish what they would like for lunch and tea, as choice is available for both. Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 13 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 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care they, or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. EVIDENCE: The AQAA sent back by the home indicated that 2 complaints have been received by the home since the last inspection. We saw that these had been fully recorded, investigated and appropriate action taken. The CSCI have received no complaints about the home since the last inspection. In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this, all had received training about Protection Of Vulnerable Adults (POVA). The home has recently been the subject of 3 safe guarding adult investigation. One has been resolved and 2 are currently under investigation by the Local Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 14 Authority. At all times the home acted accordingly in reporting the instances as this ensures the safety of the people who live at the home, this is in accordance with the proper procedures. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who live at the home experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in home which is generally safe and clean, however the home does need some redecoration. EVIDENCE: The design and layout of parts of this home makes getting about independently for some people difficult. Two upstairs areas have rooms on a different level, accessed by three steps; the manager stated assessments are made to ensure only ambulant people use these rooms. The home provides a ramp for access to these areas for those people who need to use a wheelchair. Strict health and safety policies and procedures mean this is only possible with assistance from the staff. People cannot use the ramp independently due to the risks they may encounter. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 16 Bedrooms are highly personalised and it is clear that the people who live at the home and their families are encouraged to bring memorabilia and personal items with them. The carpets on the ground floor have all been replace following the securing of a grant, however the rest of the home is need of redecoration. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. EVIDENCE: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant, and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. There is a separate rota for night staff. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer; an application form which Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 18 identified gaps in employment and a completed Criminal Record Bureau (CRB) check. There is a training and development plan in place that shows all staff have undertaken core training and that some staff undertake more specialised training such as Challenging Behaviour, Dementia and Palliative care. We saw that staff records include information about individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as appropriate to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and safety, Manual handling, Basic Food Hygiene, First Aid and Fire. Staff receive regular supervision and developmental opportunities are given for the staff to attend further training. When we spoke with staff they said they found the training excellent and where pleased that the managers encouraged them to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection (CSCI) and holds the Registered Managers Award. When we spoke with the people who live at the home they said he was approachable and they felt confident that they could go to him if they had any concerns. The staff also said he was approachable and they could go to him for advice or guidance. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 20 The people who live at the home do not have formal group meetings but are consulted on a one to one basis. An annual survey is made to determine people’s satisfaction with the care and services provided. The home has a certificate for the local authority quality development scheme. The AQAA completed by the home indicates all policies and procedures are reviewed annually and the manager confirmed changes are also made as necessary. People who live at the homes and/or their families continue manage their own financial affairs, some personal monies are kept by the home. The home promotes the health, safety and welfare of people there and the staff. Mandatory training and updates are all taking place and a health and safety poster is displayed in the laundry for all staff to see. All the relevant maintenance certificates were available for us to look at. We saw that all the appliances had been serviced since the last inspection. At the last inspection it noted that the staff were not undertaking the required amount of fire training during a twelve month period; this has now been addressed an we saw that staff had had fire training since the last inspection and they were involved in regular fire practises. The AQAA returned by the home was comprehensively completed and showed that the home had plans for future improvement. It showed that the home had identified areas of improvement and were addressing these. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 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 X X 3 Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations The home should devise an extensive refurbishment programme. Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 23 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 Ashleigh DS0000000834.V363197.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!