Care Home: Ashley Court Care Home

What the care home does well Peoples needs are assessed prior to moving to the home and care plans produced from this information. These are well detailed and provide staff with detailed information on which to care for people safely. Health care is good, and medication is given appropriately. People are treated with dignity, and are asked to contribute to the running of the home, where they and their relatives take part in Quality Assurance (QA) procedures. This is where people respond to written and verbal prompts, to see if the home is delivering the services people require. People are offered opportunity to take part in activities and pastimes, with appropriate staff and voluntary support. These and the menus are offered to people in a way that prompts peoples understanding, with pictures assisting peoples choice. Staff are well trained, and are knowledgeable in many areas. Though this training they are able to keep people safe, and have demonstrated they could act independently if required. Health and safety is good, with staff performing a number of routine tests on areas throughout the home. Comments passed by people living and working in the home included, we are a team, as well as the service users we try to help each other" "we also learn from the residents, they are very interesting". staff said that "part of our job is to help families understand the problems". "we all discuss planned time off with the manager, and if we are going to be off the manager tries very hard to try and cover the time with regular staff". What has improved since the last inspection? The manager has now registered with the Care Quality Commission. Care plans have gave a greater degree of detail, and are now more personalised. An activities organiser has been employed, she and a volunteer assists with activities. Increased numbers of staff. What the care home could do better: Some areas were mentioned in the AQAA where the staff have recognised improvements need to be made, these include: Improving the personal development plans. which is identified through the revamped supervisions. Staff trained to be more aware of dementia. To continue to provide the staff with opportunities for personal development through supervisions. To continue to improve the environment. To continue to have good links with outside services. Key inspection report Care homes for older people Name: Address: Ashley Court Care Home Reservoir Road Kettering Northants NN16 9QT     The quality rating for this care home is:   three star excellent 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: Keith Williamson     Date: 0 8 0 6 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 26 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 26 Information about the care home Name of care home: Address: Ashley Court Care Home Reservoir Road Kettering Northants NN16 9QT 01536482777 01536415654 managerashley@regalcarehomes.com www.regalcarehomes.com Regal Care Homes Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Louise Joyce Powell Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: By agreement 1 (one) male service user is accommodated with needs within the category of MD(E) No person in the category DE(E) can be admitted into the home when there are 38 people within the DE(E) category already in residence. Date of last inspection Brief description of the care home Ashley Court is a care home providing personal care and accommodation for 38 older people over with dementia or dementia related illness. Ashley Court is owned by Regal Care Homes Ltd. The home is situated in a residential area on the outskirts of Kettering town centre. It is set within its own grounds and has an enclosed garden area. There are parking facilities at the rear of the building. Care Homes for Older People Page 4 of 26 Over 65 38 0 Brief description of the care home Accommodation is on two floors and all bedrooms are single with en suite toilet facilities. A passenger lift provides access to the first floor. There are two bathrooms on the ground floor and three on the first floor. Communal facilities consist of two loungedining rooms on the ground floor and a lounge and a dining room on the first floor. There is a small room on the ground floor available for private meetings. On the first floor there is a sensory room. The current range of fess range from £405.02 to £560.00. The fees include personal care, accommodation and meals and a full explanation of what is covered is in the contract or terms and conditions of the stay. Extra costs not covered by this fee include chiropody, hairdressing, personal newspapers and toiletries. Care Homes for Older People Page 5 of 26 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: three star excellent 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: The focus of the inspection is on outcomes for service users and their views of the service provided. The main method of Inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case three service users were chosen. This visit took place over one day, commencing at 9.30am and took six hours to complete and also involved an Expert by Experience. The Expert by Experience is a volunteer who has substantial links to people who have experienced residential care. The expert took the opportunity to talk at length with service users. The Inspector talked with the registered manager and staff, looked around the home, view records, policies and care plans. Comments made to the Expert by Experience, and Inspector have been included in this report. Information was obtained from the Care Homes for Older People Page 6 of 26 Annual Quality Assurance Assessment (AQAA), which gives information about the home, and is filled in by the registered manager. A copy of the last Care Quality Commission (CQC) report is displayed in the foyer of the home, and copies of this report are available from the registered manager. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. Care Homes for Older People Page 7 of 26 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. Care Homes for Older People Page 8 of 26 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have developed a comprehensive admission pack, which is in a format suitable for peoples needs, enabling an informed decision regarding a stay at the home. Evidence: People receive information prior to moving into the home in the form of a Statement of Purpose and Service User Guide. These documents and an accompanying leaflet, give people enough information to consider a stay at the home. The information is detailed and is updated regularly, specifying what is covered in the fees and what people would be expected to pay over and above. People have a contract in place, this gives detailed information on the fees charged for the persons stay. The home does not offer intermediate care, which is a specialist type of care and Care Homes for Older People Page 11 of 26 Evidence: support following a hospital discharge. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by having their care, healthcare and medication well planned and delivered appropriately. Evidence: Care plans are being changed to offer a far greater level of detail, which enables staff to offer an excellent level of personal care for people. These are reviewed on a regular basis, and the service user or their family are asked if they wish to contribute at the review meetings. This demonstrates that the home is working with people to make their stay as pleasant and satisfying as possible. Staff are encouraged to record in daily records, these records being well detailed. Risks to people are dealt with in the form of risk assessments, which reduces the impact of potential incidents for people. Medication has improved greatly with no missing signatures in the administration record, these are also called MAR charts. Bulk medications are accurate and have a countdown system in place, this ensures staff how much medication should be in Care Homes for Older People Page 13 of 26 Evidence: stock, and makes checking this much easier. We call these checks audits, and these are undertaken by managers based both in and out of the home, on a regular basis. People are treated with respect and dignity, staff were observed to knock and wait for a reply when entering bedrooms and to assist people with personal care. The Expert by Experience observed the following. In the main lounge the chairs were arranged in small circles and the residents chatted amongst themselves. They were also very active many of them walking about with their zimmers to a different area, sitting down and talking. Where possible all the service users were brought downstairs. I was told being with more people gives the service users stimulus and it also helps the carers. The service users were allowed to go up and down in the lift. I queried this and was told we keep a close eye on those service users who we know like to go in the lift. They only have the corridors upstairs to walk along or go into the quiet room or lounge upstairs and we follow them. One of the service users nearly always goes into the quiet room after dinner. In many of the service users rooms there were charts which the staff filled in whenever they went into a room and entered what they had done, the time they left and how much the service user had eaten. I was told that details were kept on the amount that many of the service users had eaten because they forget they have eaten. One of the service users does not have English as a first language and the family have helped to compile a book to help the staff converse if there is clarification needed. Care Homes for Older People Page 14 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. With the employment of an activities organiser service users are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. Evidence: Activities are offered on a more regular basis, since a new activities organisor was employed at the home. The staff group and volunteers continue to do activities as well, and records are well detailed of what people have accomplished. The employment of an activities organisor is over and above the minimum standard but is a valuable addition to the staff group. People are offered choice, with one service user confirming they have a bedroom key. Meals are of a good quality. Menus are produced on a four week system and have pictures added, so assisting people with their choice. The Expert by Experience saw people being offered meals, and in most cases had a choice of plated dinners, again this assists confused people in their choices. The Expert by Experience observed the following. The activities organiser comes in afterternoons and evenings, and arranges different activities mainly during the early Care Homes for Older People Page 15 of 26 Evidence: evening. Most of the activities are aimed at small groups of three or four service users or less. All service users, even the few that stay in their own rooms, are included in the activities but not all at the same time. The staff take the service users into the home garden and also round the nearby park if it is fine. On the wall in the foyer was a picture book of the weeks menus day by day. I was told that in the care plan of the service users there was a note of the service users food likes and dislikes. Two of the service users did not want their dinner at the time, but after a while they were both gently persuaded to eat at the table. After breakfast the carers hold a conversation with the service users and and during this time the menu for the day is described. The service users then make their choice, though when the dinner was served some service users were unsure what they wanted. The carer then brought two plates with two selections (the day I visited it was chicken or beef stew) and again prompted an informed choice. The food looked appetising, and some of the service users had a plate guard to assist their independence when eating. A few service users were assisted to eat by the carers. There was very good interaction between the carers and service users if they were being fed and there were many carers on hand to encourage the service users to eat. Care Homes for Older People Page 16 of 26 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 are protected by staffs knowledge and actions around complaints and protection issues. Evidence: We looked at the complaints files. These showed that eleven complaints had been recorded since we last visited. The policy and procedure have been revised and had up to date contact information added. One complaint was made directly to the Care Quality Commission (CQC), again this was handled appropriately. Staff showed a good knowledge of complaint and protection issues, where they were able to explain how to protect people in the home. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment that is appropriate to the specific needs of the people who live there. Evidence: The home is comfortable and homely. Improvements have continued, with the ongoing redecoration programme and the replacement of flooring in several areas of the home. The staff are aware of the dangers of cross contamination and cross infection issues, and have routine tasks in place to deal with these. Staff have confirmed a plentiful supply of protective clothing which also assists in keeping the transfer of infection to a minimum. Laundry facilities are good, which also adds to the protection of people. The Expert by Experience observed the following. The whole time I was there a cleaner was working either upstairs or on the ground floor. All the bedroom doors had a number and a photograph of the service user, which enabled the service user to recognise their room. I looked at the garden from above and out of the door. The door was coded and I was told on very hot days it was left open and the service users could wander out into the garden and there was always staff on hand. There were plenty of seats and tables for the people. Care Homes for Older People Page 18 of 26 Evidence: I spoke to the laundry lady, and was surprised at the amount of slippers and shoes that were for washing/cleaning as well as soft toys for washing. She said the service users do not know when they have had an accident, and indicated the staff like to be on top of things and keep people clean. In the foyer, there were directions to the toilets, bedrooms, etc. I would suggest that these also have pictures of the facilities on them. There were pictures when you reached them and if pictures were on the original notice it would join them up. Care Homes for Older People Page 19 of 26 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 are protected through a thorough recruitment process and good staff levels. Evidence: We had full access to the staff files. These had the appropriate proof of identity, references and legal checks in place, to enable working with vulnerable people. The staffing numbers have increased, and this has meant care staff spend more time with Service Users. Staff confirmed they continue to go through the recruitment process prior to commencing their training induction. There is a revised training plan, and staff confirmed what training they had undertaken recently. We spoke to a recently employed member of staff who gave a good account of the recruitment and induction process. The Expert by Experience observed the following. I spoke to six members of staff in the home. They were all very cheerful and one added I enjoy my job. Another told me we are a team, as well as the service users we try to help each other and we also learn from the residents, they are very interesting. The service users were in an advanced stage of dementia and there were no visitors whilst I was there. The staff said that part of our job is to help families understand the problems. I spent Care Homes for Older People Page 20 of 26 Evidence: approximately 20 minutes in the large lounge and about the same time in the second lounge which is also a dining room just observing the interaction between carers and service users. From the large lounge I could also see some service users sitting in the porch area. I observed the carers giving both positive personal care and positive social interaction. These were expressed such as talking to the service users who kept asking for her shoelaces to be tied tighter, and having a beneficial conversation about their hair, dinner and other topics. Comments made by people on the day included we are a team, as well as the service users we try to help each other we also learn from the residents, they are very interesting. staff said that part of our job is to help families understand the problems. we all discuss planned time off with the manager, and if we are going to be off the manager tries very hard to try and cover the time with regular staff. Care Homes for Older People Page 21 of 26 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. People live in a home that is safe and well managed. Evidence: The manager has completed the process to become a registered manager with the Care Quality Commission. Quality Assurance (QA) is where the staff gain knowledge from people how well the home is performing, or where it needs to develop. Questionnaires have been circulated to service users, the relatives, medical professionals (such as the GPs) and staff. Quality assurance is built into many of the tasks and communication with residents and relatives. For instance the signing in book has two columns where people can indicate if satisfied or not with their visit. This demonstrates the manager and staff continue to seek improvements in the home. Any outcomes form any QA exercise are displayed in the foyer of the home. Staff indicated supervision and staff meetings are offered regularly. Staff supervision Care Homes for Older People Page 22 of 26 Evidence: is where staff meet with a manager and their personal work practices are looked at, and future training needs planned for. Some Service Users have money held within the safety of the office. We looked at the records of three people, all the records were up to date, the balances correct and accounting easily followed. Health and safety is monitored, with staff performing a number of tasks ensuring the safety of people in the home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 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 2 8 12 It would be useful to highlight the times medication should be given this would assist staff in the process. With the assistance of the activities person, to help the service users in the home, they could produce items such as a collage which they service users could relate to, could be hung on the walls. Perhaps more photographs of the people doing activities. It would be useful where there are directions to the toilets, bedrooms and other parts of the home, it may help people to also have pictures of the facilities on them. 3 22 Care Homes for Older People Page 25 of 26 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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